I have this sudden strong heart beat

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Submitted by Dr T on July 25, 2011 – 7:10am

For the last year (at least), I have had a strange intermittent feeling in the middle of my chest.  It feels as though my heart beat stops, pressure builds up and then there is a sudden strong heart beat.  I’m not sure how regularly this happens as I only seem to notice it when I’m resting, in which case it can happen every 5 minutes or so or not at all. I am a 37 year old woman, slightly overweight (about 14 pounds), reasonably fit but have smoked for the past 20 years (around 20 per day).  I am currently trying to quit and have managed to cut down to about 2-3 per day with some NRT.  Your opinion would be greatly appreciated!

I think symptoms like yours (Palpitations or arrhythmias) are often described as a vague “fluttering” in their chest or the feeling of a “skipped beat,” while others note a “pounding sensation” or feel that their hearts are “jumping out of their chest”.

In women palpitations are sometimes associated with a premenstrual syndrome, pregnancy or  menopause. Palpitations may cause your heart to work inefficiently and thus cause less blood to circulate around your body. When that happens you may experience some of the following sensations:

  • Dizziness or feeling light-headed
  • Shortness of breath
  • Chest discomfort
  • Weakness or fatigue (feeling very tired)

If any of these occur you need to be evaluated by a doctor sooner rather than later! Since this “extra beat” appears a new symptom for you, the first thing to find out is whether your heart is healthy otherwise, so you need to see your doctor to have some blood tests (including Thyroid), an EKG and 24 hour Holter monitoring. I have blogged about palpitations and PVCs many times before.

You can read more about that here:

Causes of palpitations include :

  • A variety of underlying cardiac conditions, including coronary artery disease, cardiomyopathy, mitral valve prolapse, etc:
  • Abnormal levels of electrolytes (minerals) in the blood. Decreased potassium and/or magnesium are the most common associated abnormalities of electrolytes. Both may be caused by the use of diuretics (water pills), among other reasons.
  • There are unusual congenital (familial) causes of ventricular arrhythmias.
  • Abnormal conditions such as increased thyroid hormones, and others.
  • Toxins, including alcohol.
  • Stimulants such as
    • Caffeine, Nicotine and/or Cocaine can cause serious ventricular arrhythmias.
    • Some over-the-counter medications and herbal/natural formulations contain important stimulants
  • Infection, inflammation or degeneration of the heart muscle.
  • Infections at other sites in the body.
  • Palpitations are often worse with lack of sleep, or stress.

The tests will confirm whether there is a heart or other problem that will need medical treatment. You should focus on cutting out Caffeine, Nicotine and stress if possible, since that may help in the meantime. Palpitations are rather common complaints and if your heart proves OK, most people don’t need treatment, only reassurance once their heart proves OK.

Hope this helps,

Dr T

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