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Felt a missed heartbeat. What are the complications?

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Practicing since : 1966
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the other day i was driving and felt my heart beat changed pace!! was so scary i had to pull over, it felt like my heart stopped and then beated very hard the next beat as if pumping hard to keep going, i felt like fainting, dont know if because i got so scared or what happened. I have never ever had any problems, i have actually done a heart scanning thing for a cosmetic surgery i done a couple of years ago and there was nothing wrong. I do sometimes feel my heart skip a beat or change pace i am not sure, but from time to time i feel that too but nothing that i feel i should worry but this time i got scared, is this a sign of something? I eat healthy but am not very active. I am also going through a very emotionally stressed period, I am 1.65cm tall and 47kg so i have not much fat in my body. recommendations please? thanks :)
Posted Fri, 2 Nov 2012 in Heart Rate and Rhythm Disorders
Answered by Dr. Anantharamakrishnan 44 minutes later

Your description is typical of 'missed beat'...As a matter of fact, the beat is not missed -it comes early / so there is a longer pause after that and the next one is a bit more forcible because of delay. It is called premature beat or extra systole. Usually the beat itself is not felt; it is the following forcible beat that is appreciated by most people.
It can be present in normal people. The common cause is anxiety (tension). Smoking is responsible in many. Too much Coffee or Cola is the cause in many. There are several other reasons - including heart disease in some!
Generally they are harmless - called benign. Usually, no treatment is needed.
However, for a proper assessment and assistance, we need to examine the patient first. Then we have to do investigations. An ElectroCardioGram (ECG) - routine 12 leads is the basic one. Then there are more - 24 or 48 hour ambulatory monitoring of ECG (Holter) is the next step. An ECHOcardiogram to assess the valves, walls and function is a routine. A basic laboratory work like blood count and sugar - sometimes hormones like thyroid function tests are done. Very often they are negative and reassuring / more often to exclude than to rule in.
Generally no drastic treatment is necessary. Reassurance, relaxation techniques, stopping smoking, reducing or stopping coffee, cola and carbonated drinks - will help most people. If still symptomatic, beta blockers are started - they help both anxiety and missed beats.
There are several other issues - depending on the complexity of the cases, which are dictated by the findings on routine tests and follow up. Most of the cases do not require most of the things - except basic work up
In summary, see your Internist or Cardiologist / Do not worry / All will be well
Wishing you a speedy recovery / Good luck
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