What It Means When Your Heart Skips a Beat

Palpitations make you feel like your heart is beating too hard or too fast, skipping a beat, or fluttering. Palpitations can happen at any time, even if you’re resting or doing normal activities. Although they may be startling, palpitations usually aren’t serious or harmful. However, they can sometimes be related to an abnormal heart rhythm that needs medical attention.

Palpitations can appear out of the blue and disappear just as suddenly. They can be linked with certain activities, events, or emotions. Some people notice their heart skipping a beat when they are drifting off to sleep; others, when they stand up after bending over. Palpitations can be triggered by:

1. Stress, anxiety, or panic
2. Dehydration
3. Low potassium
4. Low blood sugar
5. Too much caffeine, chocolate, or alcohol
6. Fever

If you have unexplained palpitations, start with the simple things first:

• Don't smoke.
• Cut back on alcohol, or stop drinking it altogether.
• Make sure you eat regularly (low blood sugar can cause heart palpitations).
• Drink plenty of fluids.
• Get enough sleep.

Stress and anxiety are two other key triggers of skipped beats. A two-step approach can help here. To keep palpitations away, try meditation, the relaxation response, exercise, yoga, tai chi, or another stress-busting activity. If palpitations do appear, breathing exercises or tensing and relaxing individual muscle groups in your body can help.

Deep breathing. Sit quietly and close your eyes. Place one hand on your abdomen. Breathe in slowly and deeply through your nose. Feel your abdomen move outward. Exhale through your nose or mouth, whichever feels more comfortable. Repeat.

Valsalva maneuver. Pinch your nose closed with the fingers of one hand. Close your mouth. Try to breathe out forcibly through your nose.

Bear down. Clench your stomach muscles and your anal sphincter. Then bear down as if you are having a bowel movement. (This is another way to do the Valsalva maneuver.)

Cold water. Splash cold water on your face, or immerse your face in a sink or large bowl filled with cold water.

The Valsalva maneuver, bearing down, and cold water stimulate the vagus nerve, which helps control the heart rate. Deep breathing helps relax you and ease the stress and anxiety that can come with palpitations.

Call your doctor if you have palpitations with shortness of breath, dizziness, chest pain, or fainting, have someone drive you to an emergency department or call your local emergency number right away. These may be signs of a serious heart problem.