Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
142 Doctors are Online

Feel like a long pause in between heartbeats. Should I be concerned?

User rating for this question
Excellent
Answered by

Cardiologist
Practicing since : 1998
Answered : 1304 Questions
Question
I occasionally have what feels like a long pause in between heartbeats. It feels like my heart is stopped. It probably isn't as long as I suspect but it feels like forever. I estimate 2 to 3 seconds. I would like to know if this is XXXXXXX and how long of a pause would be considered XXXXXXX
Posted Tue, 26 Nov 2013 in Heart Rate and Rhythm Disorders
 
 
Answered by Dr. Sukhvinder Singh 43 hours later
Brief Answer: please see below. Detailed Answer: Dear Sir There are two aspects of this situation. First, if you have any symptoms pertaining to these pauses? If you ever had a blackout/ unexplained fall/ transient loss of consciousness/ transient dizziness, particularly in association with pause? If yes, please do see your cardiologist on priority. The second aspect is ascertaining the reason for pauses, or in technical terms, the rhythm at time of pause. Since you have frequent PVC, the pauses may be simply related to them. A PVC is a premature beat, which has an associated lower than normal pulse volume. Thus it may not be felt. The next beat after PVC comes at longer interval, such that the actual interval between the two pulse you feel is double that of normal interval. Hence you feel a pause. There can be other reasons also but will require continuous ECG monitoring like holter recording or loop monitoring. It is not only the duration which is important in determining the danger but also the cause of pause. PVC related pauses are benign. Any pause associated with symptoms is XXXXXXX Pauses arising in sinus node are benign up to 2.5 seconds unless they are associated with symptoms. Pauses due to AV node blockage may be benign or XXXXXXX depending upon type of rhythm. Hope this provides insight into issue. Feel free to discuss further. Sincerely Sukhvinder
Above answer was peer-reviewed by
 
Follow-up: Feel like a long pause in between heartbeats. Should I be concerned? 3 hours later
Is there anything XXXXXXX from what you see in the report? I thought I saw 3 beats of VT to 130 on there.
 
 
Answered by Dr. Sukhvinder Singh 6 hours later
Brief Answer: please upload report Detailed Answer: Dear Sir Sorry. There is no attached report. Please upload it. Sincerely Sukhvinder
Above answer was peer-reviewed by
 
Follow-up: Feel like a long pause in between heartbeats. Should I be concerned? 12 hours later
i am trying to upload it again. report has been uploaded Please let me know if anything looks XXXXXXX in it. Thank you
 
 
Answered by Dr. Sukhvinder Singh 1 hour later
Brief Answer: please see below. Detailed Answer: Dear Sir 1. If there was no symptoms during these runs of VT (if you were asymptomatic at time of these runs), then they do not carry much significance. They (such short runs at this rate) become important only when they are associated with symptoms. They also assume significance if they develop on background of structural heart disease (especially with ejection fraction less than 35%). However, even in these conditions they are more like epiphenomenon ( harbinger of bad prognosis, not because of there own presence but because of underlying heart condition). 2. If you were totally asymptomatic during these 24 hours of holter monitoring, there is nothing XXXXXXX in these findings. More important will be if there is an underlying structural heart disease ? If it is there, then what is the cause? What is the prognosis of that underlying condition. The prognosis of that structural heart disease will govern the future outcomes rather than the findings in this report. I hope I made it clearer to you. Still If there is a doubt please feel free to write. Sincerely Sukhvinder
Above answer was peer-reviewed by
 
Follow-up: Feel like a long pause in between heartbeats. Should I be concerned? 6 hours later
I m uploading the newest echo. Please evaluate and tell me if you see anything serious. Thank you so much for your time.
 
 
Answered by Dr. Sukhvinder Singh 4 hours later
Brief Answer: please see below Detailed Answer: Dear Sir 1. It shows Mild LV enlargement with mild LV systolic dysfunction (EF=47%) with Moderate AR. In all probability, most evident reason for this is your morbid obesity (body mass index of ~52). Rest of the causes can be deciphered by further evaluation of bio-chemistry and clinical profile. 2. I do not see any thing alarming for your holter report in view of your ECHO report (provided you did not have any symptoms which you did not mention in repeat query too). However I will be concerned about your weight which is the most XXXXXXX thing for future cardio-vascular events. You must get it down. my second-concern- Any cardiac dilatation and low pumping, even mild, predisposes to future adverse event. However, cardiac enlargement may be an epiphenomenon for obesity (the bigger trouble). Even full fledged heart failure may occur purely because of obesity (OBESITY CARDIOMYOPATHY). Hope this clarifies the scenario. Sincerely Sukhvinder
Above answer was peer-reviewed by
 
Follow-up: Feel like a long pause in between heartbeats. Should I be concerned? 12 hours later
Can these items be reversed with weight loss? (most importantly the moderate Aortic regurgitation) Thank you
 
 
Answered by Dr. Sukhvinder Singh 1 hour later
Brief Answer: please see details. Detailed Answer: Dear Sir 1. Yes, the LV enlargement will definitely reduce with reduction in weight. Possibly the LV functions will also improve, if obesity is only cause for LV dysfunction. 2. Aortic regurgitation is not directly related to obesity, hence chances of reversal with weight control are relatively less. Only possible related mechanism could be enlargement of aortic root with body large size giving rise to secondary AR (this seem plausible because description of aortic valve is otherwise normal). This may improve with reduction in weight. Sincerely Sukhvinder
Above answer was peer-reviewed by
 
Follow-up: Feel like a long pause in between heartbeats. Should I be concerned? 23 minutes later
I have a hiatal hernia and seem to get very much worse pvcs and other skips shortly after eating. Do you think the hernia could be aggravating them? I had a lot of them on the halter especially when I was nervous. Thank you for taking the extra time on this. It has helped me a lot.
 
 
Answered by Dr. Sukhvinder Singh 23 minutes later
Brief Answer: Please see details. Detailed Answer: Dear Sir 1. One of the Basic causes of VPCs is a mis-match in sympathetic and parasympathetic drive. These two drives excitatory and inhibitory respectively control our heart too. Anything which brings a mis-match between two can induce it in a given individual. Same may be true for postprandial stimulation of nerves in case of hernia. This is only speculative. However, as they are benign phenomenon and do not carry any risk of their own, their aggravation even by hernia is not a matter of concern, unless you have symptoms because of them. 2. Nervousness will increase them by increasing sympathetic drive. It is well known. hope this helps. Sincerely Sukhvinder
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+

The user accepted the expert's answer

Ask a Cardiologist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor