Hi friend,
Welcome to Health Care Magic

This feeling of ‘dropping / skipping / missed’ beat points ECTOPIC beats.
A beat comes earlier than normal – this itself is not usually felt. The next beat is a bit delayed - longer time to recover form early extra beat – so heart fills more and the beat appears forcible – thud / lubb - - dubb - - lubb - - dubb - lubb - - - DUBB /

Ectopic beats can arise from ventricle (lower chamber of the heart - Ventricular Ectopic; VPC) or Atrium (upper chamber - Atrial Ectopic; APC).
APCs are generally harmless. Even VPCs are often harmless – ‘benign’.
If they are frequent - more than 5 per hour, 2 or more beats coming consecutively – they should be investigated further.

Irregular heart beats need to be DOCUMENTED by ElectroCardioGram (ECG / EKG).
THE FIRST STEP IS TO SEE A CARDIOLOGIST
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     Anxiety / Alcohol / Tobacco (smoking, chewing) / Caffeine (too much coffee, cola) are common causes.
     Medicines may be responsible – like Phenylephrine / Salbutamol, Salmeterol used for asthma and so on.
Illicit ‘drugs’ like Amphetamine are notorious to cause abnormal beats
     At times, abnormal nerve paths in the heart (bypass tracts) are responsible!
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These beats are common and often may be normal.
Yet it is advisable to have it investigated.

A thorough history and physical examination is the first step -
ECG (Electrocardiogram / EKG) – Routine 12-lead – is part of clinical examination.
     HOLTER (24 to 48 hour ambulatory monitoring) is done to analyse and plan for further management, if a routine ECG does not show,
     ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality).
      TMT (Treadmill exercise ECG) is done to exclude Ischemia (reduced blood flow).
     LABORATORY work-up is routine - like blood counts, sugar, urea, electrolytes (potassium in particular), thyroid (over-active) and so on. Your Internist shall suggest based on the situation.
     If there are no clues and if the problem is still bothering to the extent of interfering with life style, there advanced techniques of investigations of increasing complexity – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and has a risk (though minimal) and is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation.
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     Specific treatment may not always be necessary.
     The first line medicine is generally beta blockers, like Metoprolol – slow release and small dose. It will benefit both anxiety and missed beats. Your doctor will give proper prescription and follow up
     If they are not effective and if the problem is severe, several other classes of drugs are available – acting by different mechanisms - the specialist will decide tailored to your needs / they may have side effects and need follow up.
There are other advanced treatment modalities - like RF ablation, which could be done during EPS.

Take care
Wishing speedy recovery
God bless
Good luck

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Hi

It can happen to everybody - at some point of time.
Whether it is normal or else in a given individual - can only by ascertained by further investigations.

Regards

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Hi,

The foot baller is said to have had undiagnosed heart muscle disease - Cardiomyopathy. He had no symptoms.

That you have a symptom - is probably a blessing in disguise - to get investigated and reassured. If you diagnose a rare disease, you are rarely correct. Common things are common. And most likely, you may not have anything serious at all. Anxiety causes arrhythmia > arrhythmia causes anxiety > a vicious cycle, it turns out. Relax / See your doctor / do the tests - more to rule out and reassure than anything else.

All the best
God bless you

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