Heart missing a beat


28 August 2019

Did you know that your heart beats around 100,000 times a day, and it keeps about 5 litres (eight pints) of blood constantly circulating around your body?

The sound of another beat

Most of the time you probably don’t notice the hard work your heart carries out, because, if it’s healthy, it just gets on with the job. But occasionally the silent rhythm of your heartbeat is disturbed, and you experience what feels like a missed beat.

“Quite often it can feel as though your heart has stopped and re-started,” says Nikki Porges, a registered nurse in our Health at Hand team.

“Actually what it’s doing is adding an extra (or ectopic) beat, but that beat is not very effective, so the following heartbeat is much more powerful. That’s because it’s doing all the work that that extra heartbeat didn’t do, plus all the work it has to do itself. It can feel like a kind of thump in the chest.”

Is that extra heartbeat a problem or can you just put it down to stress?

“In most cases, it’s nothing to worry about. If you have no known heart disease, are young and follow a healthy lifestyle, and this happens when you’re at rest, it’s usually not a problem,” says Nikki.

Being stressed, for instance if you have to make a speech or attend a job interview, can trigger the release of abnormal amounts of adrenaline, which can make your heart beat out of rhythm. Panic attacks caused by stress and anxiety, smoking, too much caffeine from coffee and/or energy drinks, over-exercising or running fast for the bus can have the same effect.

Try changing your habits – drinking less coffee and relaxing your mind and body − and see whether it makes a difference to when and how often you have palpitations.

Take a look in your medicine cabinet as well, because some medicines can trigger palpitations. These include thyroid medication and asthma inhalers. If you think these may be the trigger, it’s worth asking your GP if there’s an alternative you can use.

When to see your GP about an ectopic heartbeat

There are situations when you need to see your GP. “If you have known heart problems, such as heart failure or angina, and feel that missed beat, you should see your doctor,” says Nikki. “If you have palpitations when you are exercising, that can be a cause for concern. And if that ectopic beat happens a lot, and it’s worrying you, again, see a clinician.”

Some medical conditions can cause your heart to beat irregularly. If you suffer from any of these − or think you might − you may need to take medical advice. These include:

  • Dehydration
  • Fever
  • Low blood pressure
  • Arrhythmia – a condition when your heart beats irregularly, too fast or too slow. (You can download the Heart Rhythm Checklist from the Arrhythmia Alliance – see below.)
  • Atrial fibrillation − a condition where your heart can beat erratically, and which can increase your risk of stroke and heart failure.
  • Supraventricular tachycardia (SVT) – a condition where your heartbeat is usually regular, but can have periods of beating faster than normal.

Be pulse aware

“I advise all my patients that they should be pulse aware,” says Nikki. “It’s easy to take your pulse rate, and it’s something we should all do. Put one hand flat, palm upwards, on a flat surface. Place your first and middle finger on your wrist, at the base of the thumb, and count the number of heartbeats you feel per minute.”

Most healthy adults have a resting pulse rate of between 60 and 100 beats per minute. If you're fit, and do regular exercise, your heart rate may be lower. However, if your heart rate is continuously over 120 or under 40 beats per minute, you should see your doctor.

“If your heart is constantly racing, you could be at risk of heart failure; if it's slow, you might need a pacemaker,” says Nikki. Checking your pulse rate regularly is also a good way of finding out if your heartbeat is regular.

Whether your pulse is regular, erratic, fast or slow, it’s important to take the best possible care of your heart. “Make sure you have a well-balanced diet and aintain a healthy weight,” says Nikki. “Eat plenty of fruit and vegetables, and starchy foods like potatoes, bread, rice and pasta. Include smaller amounts of fish, eggs and beans. Be strict about how much fatty, sugary foods you have, and try to avoid high-cholesterol foods.”

“You can drink alcohol in moderation (as long as you don’t have other medical reasons to avoid it). Take regular exercise  − at least 30 minutes five times a week – and try to build it into your daily routine. And don’t forget to drink plenty of water and keep yourself hydrated.”

Visit our heart centre for more information on heart health or read our lifestyle articles which provide tips on caring for your heart health.

Further reading

Fitting change into your lifestyle - AXA PPP healthcare

Ten ways to develop healthy eating habits - AXA PPP healthcare

How much is too much alcohol - AXA PPP healthcare

Dehydration - are you at risk? - AXA PPP healthcare

Heart centre - AXA PPP healthcare

Useful information

Arrhythmia Alliance

Atrial Fibrillation Association

British Heart Foundation