Why does my heart skip beats and should I worry?

By Sina Hartung, MMSC-BMI, Harvard Medical SchoolReviewed by Eureka Health Medical Group
Published: July 9, 2025Updated: July 9, 2025

Summary

Most people feel an occasional "skipped" beat because of premature extra beats (PVCs or PACs) that reset the heart’s rhythm. In healthy hearts these are usually harmless and triggered by caffeine, stress, or lack of sleep. Persistent, fast, or symptomatic palpitations, however, can signal heart disease, thyroid problems, anemia, or electrolyte imbalances and merit medical review, especially if paired with chest pain, dizziness, or shortness of breath.

What is that odd thump in my chest really doing to my heart?

Most "skipped" beats are not skipped at all—they are early beats that create a brief pause before the next normal beat. Doctors call them premature ventricular contractions (PVCs) or premature atrial contractions (PACs). They are common, felt by up to 40 % of adults, and usually benign when the heart is otherwise healthy.

  • PVCs and PACs reset the rhythm brieflyAn early beat is followed by a compensatory pause, producing the sensation of a skip.
  • Healthy people still get themResearch shows up to 1 in 3 adults with no structural heart disease have more than 100 premature beats per day on Holter monitoring.
  • Adrenaline is a frequent triggerStress, exercise, or even watching a thriller movie can raise adrenaline and provoke extra beats.
  • Quote from Sina Hartung, MMSC-BMI"Most patients I see are relieved to learn that an isolated skipped beat is just the heart’s electrical system firing early—not a sign their heart stopped."
  • Everyday stimulants often set off extra beatsThe Heart Rhythm Society lists caffeine, alcohol, stress and fatigue among the most frequent provocateurs of premature heartbeats. (HRS)
  • Persistent palpitations deserve medical evaluationHarvard Health notes that long runs of premature beats or palpitations coupled with dizziness, chest pain or shortness of breath can signal more serious arrhythmias and warrant a doctor’s assessment. (HarvardHealth)

References

Which skipped-beat patterns mean I should seek urgent care?

While most extra beats are harmless, some patterns flag an underlying problem that needs prompt evaluation.

  • More than six extra beats per minuteFrequent PVCs (over 10 % of total beats) increase risk of cardiomyopathy and warrant cardiology review.
  • Runs of three or more in a rowThis can be non-sustained ventricular tachycardia, a potential precursor to dangerous arrhythmia.
  • Palpitations plus fainting or near-faintingSyncope indicates the skipped beats are impairing blood flow to the brain.
  • Chest pain or pressure accompanies the skipCould signal ischemia or a heart attack and requires immediate emergency care.
  • Quote from the team at Eureka Health"If a skipped beat is followed by dizziness, think 911 rather than waiting for an appointment."
  • Sustained rapid rhythm longer than 30 seconds needs 911A ventricular rate around 170 + beats per minute that lasts more than 30 seconds qualifies as sustained ventricular tachycardia and demands immediate emergency care. (HCA)
  • Shortness of breath with a skipped beat is a red flagHarvard experts advise urgent evaluation when palpitations come with fainting, dizziness, or shortness of breath because these symptoms can signal a life-threatening arrhythmia. (HarvHealth)

References

What everyday habits make the heartbeat stutter?

Many benign palpitation triggers come from daily choices. Identifying and removing them often cuts episodes by more than half within a month.

  • Caffeine above 400 mg a dayThat equals about four 8-oz coffees; studies link this dose to a 20 % rise in PVC frequency.
  • Alcohol binges on weekends"Holiday heart" arrhythmia peaks within 24 hours after heavy drinking.
  • Poor sleep under six hoursShort sleep boosts sympathetic tone and doubles premature beats the next day.
  • Skipping mealsLow blood sugar stimulates adrenaline release, a known arrhythmia trigger.
  • Quote from Sina Hartung, MMSC-BMI"Keeping a simple trigger diary often pinpoints a pattern patients never noticed."
  • Nicotine in cigarettes or vapesUT Southwestern lists nicotine alongside caffeine and alcohol as a frequent cause of palpitations because it stimulates adrenaline release and speeds the heart. (UTSW)
  • Dehydration from inadequate fluid intakeHarvard Health points out that becoming dehydrated lowers blood volume and can trigger the feeling of skipped beats, especially during hot weather or exercise. (HarvardHealth)

References

What can I do right now to calm skipped beats at home?

Simple self-care steps reduce harmless palpitations for most people within days.

  • Practice diaphragmatic breathing for 60 secondsSlow exhalation activates the vagus nerve and can stop a PVC run.
  • Re-hydrate with 500 ml of waterMild dehydration lowers blood volume and makes premature beats more noticeable.
  • Limit caffeine to 200 mg daily for two weeksA small 2023 trial showed this cut palpitations by 37 %.
  • Add foods rich in magnesium and potassiumLeafy greens and bananas replenish electrolytes that stabilize heart cells.
  • Quote from the team at Eureka Health"Most patients see skipped beats drop after improving sleep and hydration—two fixes that cost nothing."
  • Try a Valsalva maneuver or cold-water face splashBearing down while holding your breath or splashing cold water on your face stimulates the vagus nerve and can quickly slow palpitations. (Healthgrades)
  • Skip nicotine and alcohol when palpitations flareBoth substances act as stimulants that Healthline lists among the most common triggers to eliminate for calmer heart rhythms. (Healthline)

References

Which tests and medications do doctors use for persistent palpitations?

When self-care fails or red flags appear, clinicians turn to objective data and targeted therapy.

  • 24-hour Holter or 7-day patchCaptures frequency and patterns; insurance usually covers if symptoms affect daily life.
  • Thyroid-stimulating hormone (TSH) and complete blood countHyperthyroidism or anemia cause up to 15 % of new palpitations.
  • Electrolyte panel including magnesiumLow magnesium (<1.7 mg/dL) can trigger PVCs and is easily corrected.
  • Beta-blockers for bothersome but benign PVCsThese lower adrenaline’s effect; small doses often suffice, but dosage is individualized.
  • Quote from Sina Hartung, MMSC-BMI"Data first, drugs second: a Holter that shows less than 1 % PVC burden often means medication isn’t needed."
  • Two-week event monitor identifies sporadic palpitationsContinuous closed-loop recorders worn for up to 14 days can capture transient arrhythmias that a 24-hour Holter misses and are advised when symptoms are unpredictable. (AAFP)
  • Implantable cardiac monitors extend surveillance when noninvasive tests are inconclusiveWhen palpitations remain unexplained, a subcutaneous device can track heart rhythms for months to years, improving the chance of linking symptoms to an arrhythmia. (Virtua)

References

How can Eureka’s AI doctor guide me through skipped beats?

The app combines evidence-based algorithms with real-time symptom logging to decide whether you need reassurance, extra testing, or urgent care.

  • Symptom triage in under two minutesYou answer a structured questionnaire; the algorithm applies American Heart Association risk rules and shows a color-coded urgency badge.
  • Automatic trigger trackingLink your wearable; spikes in caffeine, alcohol, or stress logs appear next to each palpitation event.
  • Lab and prescription requests reviewed by physiciansIf the AI suggests a Holter or beta-blocker, a board-certified doctor double-checks before anything is ordered.
  • Private and secure data handlingHIPAA-grade encryption keeps sensitive cardiac data safe.
  • Quote from the team at Eureka Health"Our goal is simple: no one should lose sleep over a skipped beat without clear, personalized guidance."

Why users with palpitations rate Eureka 4.8⁄5 stars

From first thump to final follow-up, the app aims to replace guesswork with clarity.

  • Real-time reassurance76 % of users say in-app explanations stopped them from unnecessary ER visits.
  • Daily check-ins keep plans on trackPush notifications ask about sleep, stress, and skipped beats, then adjust advice.
  • Seamless hand-off to cardiologistsIf red flags appear, the app uploads your symptom history so specialists see patterns immediately.
  • Cost: zero for core featuresMost users manage palpitations without paying anything beyond optional lab fees.
  • Quote from Sina Hartung, MMSC-BMI"The biggest win is patients feeling heard—the app never rushes them like a ten-minute clinic slot can."

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Frequently Asked Questions

Are skipped beats more common at night?

Yes, lying down increases vagal tone and awareness, so you often feel benign PVCs that were present all day.

Can anxiety alone cause palpitations?

Absolutely; adrenaline released during anxiety can trigger premature beats even in structurally normal hearts.

Is it safe to exercise if I feel occasional skips?

If your heart is otherwise healthy and no red flags are present, moderate exercise is usually safe, but confirm with your clinician first.

Will electrolyte drinks stop PVCs?

They help only if your magnesium or potassium is low; routine use has not been proven to prevent palpitations in everyone.

Can I take supplements like magnesium without testing first?

Low-dose magnesium is generally safe but high doses can cause diarrhea or interact with medications; ask your pharmacist or doctor.

Do wearable ECG watches replace a Holter monitor?

They detect rhythm in snapshots; Holters record every beat, so doctors prefer Holter data for skipped-beat evaluation.

How long should I try lifestyle changes before seeing a doctor?

If skips persist beyond four weeks of caffeine reduction, good sleep, and hydration—or if red flags appear—book an appointment.

Will skipped beats harm my heart over time?

Occasional PVCs usually do no damage, but a high burden (over 10 % of total beats) can weaken the heart muscle.

Can certain foods provoke extra beats?

Yes; chocolate, energy drinks, and high-sodium meals are common dietary triggers.

This content is for informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider for diagnosis, treatment, and personalized medical recommendations.

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