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What Causes Skipped Heart Beats?

Posted on Fri, 31 Jan 2014

Question: Dear dr, Discovered skipped heartbeats 1 year ago. Went to cardio n had 2 normal EKG. Wore a 24 holtermonitor and showed 461 skipped beats. The dr told me to relax. On n off the skipped beats came. Recently came back with full force. Ok jux got my holter results and as I'm currently not in my hometown. I had to translate the readings to u. 1040am- 5 1100 - 21 1200-19 1300- 29 I had my breakfast and lunch these period of time 1400- 0 1500-8 1600-1 1700-0 1800-1 1900-0 2000-3 2100-1 2200-1 2300-8 0:00-0 Basically laying at home this period , dinner did not increase the frequency at this point of time. 1am-16 2am- 28 3am-44 4am-15 5am-29 6am-44 7am- 31 8am-24 9am-21 10am-36 Total of 385 skipped beats. ST normal. 3 beats a row once caught.lowest heart rate at 5.03am at 42bpm. Highest at 115bpm at 1309hrs. Avg 24hr heartbeat is 70bpm. Is my results normal? If my skipped heartbeats are triggered after meals like after lunch, why isn't dinner affected? However there are times when I felt a lot of skipped beats after dinner too, jux that this time round didn have I guess. Y is are there so much when I sleep? I'm so worried that it might jux stop beating while sleeping!!! Wat can I do? My heart rate is 42bpm at 5am whole sleeping ? Isn't it between 60-80 while at rest? Sometimes I turn my torso, lean over to pick something the skipped beats came , but when I try n repeat the movement again it doesn't repeatedly exist. ?? When I'm bloated or gassy. It seemed to get worse n sometimes follwed by burping gas. ? Sorry for the long reading, but it's taking a toll on my life. Pls advise

Answered by Dr. Benard Shehu (2 hours later)

Brief Answer: Foods&bradychardia trigger extra heart beats Detailed Answer: Hi dear XXXXXXX I have run your results and could say that your extra heart beats are being triggered by: - low cardiac frequency (bradychardia) - foods you eat that cause dyspepsia So, it depends on the foods you eat during each meal and how much they cause hyperacidity of the stomach and gas and bloatness to your intestines. Such bloatness will extent the abdominal wall putting pressure into the chest and cardiac cavity giving a signal to the heart which will work faster (palpitations or extra heart beat you experience). In other words, foods such as chocolate, spicy foods or citrus can cause high acidity of the stomach precipitating/aggravating gastritis/dyspepsia. This will further trigger extra systoles to you. So, if you avoid such foods and drinks and smoking or alcohol, then, you won't have problems with stomach and less or no extra heart beat at all. Now, with regards to sleeping, it is normal for the heart rate to be low when sleeping (bradychardia). This is also triggering extra heart beats explaining the high extra heart beats when sleeping. It is also normal for the heart rate to get below the resting ranges (such as 42 or less) when sleeping. When you turn quickly or movement suddenly your torso or stretching, then, you will have palpitations as a reaction of the heart to the quick and sudden movement. So, I'd advise not to move or try to catch things quickly and suddenly but take your time in order to avoid palpitations. So, you must focus on foods you eat, speed you eat and do movements in order to avoid triggering of extra heart beats or palpitations. All the best! Dr.Benard

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Benard Shehu (1 hour later)

Dear dr, Under the report there is some T- abnormality.. The dr advise me to do a ultrasound n blood test. N this T abnormality wat does it mean? And wat causes it? It's some heart disease coming? The report say T wave borderline low. Wats the cause of this? Is it serious? ST is normal. V4 V5 V6 T wave flat low. What do u tink? Is it necessary to have T wave abnormalities together with skipped heartbeats/pvc/PAC. Are they link or is there people with skipped heartbeats and yet T wave normal??? I'm worried sick. I'm going for ultrasound tomorrow Is my ECG consider normal or not normal?? ST - normal T wave - flat low-abnormal Pls advice

Answered by Dr. Benard Shehu (7 hours later)

Brief Answer: Kindly attach your ECG &other reports... Detailed Answer: Hi, The interpretation of ECG should be done by a cardiologist (It may be different from the "interpretation" made by the machine). In order to assist you specifically, I'd kindly ask to send me a copy of your ECG and not the interpretation. Please bare in mind that ECG findings are not considered as a disease always. Apart ECG, I'd also suggest to do: - measure the levels of thyroid hormones in the blood to exclude thyroid problems - do cardiac ECHO - do Stress testing. If everything is withing normal ranges, there is no need to be worried about. Looking forward to kindly have the requested data! Thank you! Dr.Benard

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Benard Shehu (27 minutes later)

The readings and reports is written in Chinese. Is it ok?

Answered by Dr. Benard Shehu (1 hour later)

Brief Answer: No problem with chinese reports,attach ECG.. Detailed Answer: Hi back, Thank you for following up. There is no problem, just send in the entire EKG and reports if any. My main goal is to look at your EKG myself. Thank you! Dr.Benard

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Benard Shehu (10 hours later)

Dear dr, I had done a echo/ultrasound and it states mild left ventricle regurgitation. I weigh 61kg height 177cm. No high blood pressure. No junk food. What causes this? Is it serious? How do manage? Is it common? Other than skipped heartbeats, I have no other symptoms? If it get serious, it's surgical the only way and how is it done? Thk u for your kind patient n understanding . Is worrying

Answered by Dr. Benard Shehu (12 hours later)

Brief Answer: Mild regurgitation cause to arrhythmia you have... Detailed Answer: Hi back, Thank you for following up. The causes to mild left ventricle regurgitation might be - idiopathic (with no known causes, normally seen in up to 15% of patients) - rheumatological disease - ischemic disorders The mild regurgitation itself could also be a cause to arrhythmia you are experiencing. Usually, it is not serious, but it requires annually follow ups by echography. With regards to the surgical treatment, I'd say it is not indicated in mild regurgitation. Meanwhile, severe regurgitation associated with severe left ventricle failure need surgical therapy. As per your case, I'd suggest to keep annual follow ups with your cardiologist and do schedule echography. The earlier advice are helpful to alleviate your symptoms. All the best! Feel free to ask me other questions you might have! Dr.Benard

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Benard Shehu (34 minutes later)

dear dr， Firstly I would like to thank u for your patience and guidance . I had problems pasting the reports to u after trying many times . I will jux summarize to u. Blood work ok, echo was normal except for mild regurgitation. Holter showed 385 skipped beats. Fastest heartrate 115bpm 1pm Lowest at 42bpm 6am I had anxiety disorder for 7 years. The cardio went thru my report and said that skipped beats are normal in people. And the mitral issue is mild. I XXXXXXX know if there is any relation to the pvcs and mitral thing? He jux asked to to check them annually. However, I got no symptoms of the mitral issue except for the pvcs that I would loved to get rid off. But now I'm confused as I XXXXXXX know whether the skipped beats are caused by the mitral issue or from my anxiety disorder ? Did my anxiety disorder caused it or the other way? I realized everytime when my skipped beats keep coming, I try and lay down or take a nap they seemed to go away only to comeback again some hours later. Any explanation? Also I felt them least when I laid down to sleep? I want to thank u again for ur guidance. I'm away from home and the drs here XXXXXXX allow you to ask more.. Patients are lining up.. I wil definitely go home to have another opinion, but would loved to hear from u or any advice ... The issues are really worrying. Thks again One more question. If the mitral issue is causing my skipped heartbeats and yet there is no way to really cure mitral regurgitation, how am I going to leave my life with the annoying skipped beats?? How do I differentiate if the skipped beats are caused by mitral issue or by anxiety disorder ? Thks again

Answered by Dr. Benard Shehu (3 hours later)

Brief Answer: Anxietytriggering palpitations... Detailed Answer: Hi again, Thank you for following up. Mitral regurgitation could be a cause to arhythmia; while anxiety is a factor triggering palpitations and arhythmia. So, they are both related. On the other hand, mitral regurgitation can cause pvcs (premature ventricular contractions). It is good that you lay down when having the palpitation attack. As your blood pressure is lowered when laid or sleeping, the extra heart beats will be reduced too explaining why you do not feel them. Although "annoying", palpitations can be controlled through simple and manageable changes in lifestyle and diet habits as mentioned earlier. At the beginning, it might seem to be difficult, but, with the passing of time you'll handle it greatly. Once again, please bare in mind that the extra heart beats are triggered by being anxious or being stress-overload. All the best! Dr.Benard

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Benard Shehu (21 hours later)

Dear dr, Thks again for ur reply. I had trouble looking at the Chinese report. But after checking with the English dictionary n friends. Echo show that heart is normal n have mild aortic n mitral regurgitation. Which is more XXXXXXX ? How common is this and wat is the statistics showing the combination of this 2 valve problem arising? I expect that having 2 instead of one is more XXXXXXX ..I googled n realise there is no cure to this only "pray " that it remain mild as long as possible.. If there is no cure to this then I will suffer skipped heartbeats for the rest of my life? The skipped beats if caused by the 2 valve issues n the valves can't be cured til sugical intervention at a more advance stage? I supposed is only a matter of time that the valves degenerated to a surgical requirement ... I have anxiety disorder and this problem only makes me more anxious. They come together now, the worst an anxiety patient can worry is heart problem n after 8 yrs of panic disorder, finally heart problem found. Is really making me real down. I guess I won't be living till old age n a surgery is likely to come in the next 10 yrs and the ability to live at most another 10 years after surgery.., I got 2 valves , so 2 surgery?? Thk u for yr patience . I understand u have a lot of patients n seen many cases, I'm away from my hometown. I need someone who understand what I'm going thru.

Answered by Dr. Benard Shehu (48 minutes later)

Brief Answer: Mild aortic&mitral regurgitation-no need to worry.. Detailed Answer: Hi again, Thank you for following up. You are saying the the ECHO report was shown mild aortic and mitral regurgitation. Neither of them is more XXXXXXX than the other. It all depends on the severity of the regurgitation and if the heart is negatively involved. With regards to your case, fortunately, you have mild aortic and mitral regurgitation with normal heart. As mentioned earlier, many people have these echo findings and are considered normal. No need for surgery, you should not think over it. So, keep your mind in peace as you have no serious problem. The most "serious" problem is anxiety. If you will control anxiety, you won't feel any problem from arrhythmia. Normally, you won't have any symptom from regurgitation, only arrhythmia which is worsened by anxiety. All the best! Dr.Benard

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Above answer was peer-reviewed by : Dr. Raju A.T