Heartbeat Irregularities: When to Seek Medical Advice

Consultation for Heartbeat Concerns

Dear Dr.
He,
This morning, while sleeping on my left side, I noticed that I could hear my heartbeat through my left ear pressed against the pillow.
I counted my heartbeats to check for regularity.
Initially, the heartbeat was a bit fast, but then it gradually slowed down, and it seemed to have a regular rhythm.
However, I noticed that there seemed to be a pause between the transition from the fast to the slow rate.

I would like to ask you, in your opinion, is the "pause" I heard a normal phenomenon during the transition of heart rate, or could it indicate that I actually experienced a "missed beat"?
2.
Following up on that, if it is indeed a missed beat, what (adverse) effects could it have on my health?
3.
Additionally, is a missed beat a normal occurrence for most people, or is it considered an abnormal situation or a disease? What factors could lead to experiencing missed beats?
Thank you, Dr.
He.

A-Xiang, 30~39 year old female. Ask Date: 2021/11/16

Dr. He Dongjin reply Cardiology

Hello, your heartbeat may indeed have "missed beats." In fact, everyone experiences some degree of missed beats; it's just a matter of how many.
Generally, this does not have any adverse effects on health unless the frequency exceeds a certain level.
If you don't usually feel it, there should be no cause for concern—just monitor it.
Don't worry.
Changhua Hospital cares about you.

Reply Date: 2021/11/16

More Info

When it comes to understanding heartbeat irregularities, it's essential to recognize that the heart's rhythm can vary significantly from person to person, and even within the same individual at different times. The phenomenon you described—hearing your heartbeat while lying on your side and noticing a change in rhythm, including what seems like a "pause"—can be concerning, but it is not uncommon.

1. Understanding the "Pause" in Heartbeat: The sensation of a "pause" or a skipped beat can often be attributed to a phenomenon known as a premature contraction. This occurs when the heart's electrical system sends out an impulse too early, leading to an extra heartbeat followed by a pause as the heart resets its rhythm. This is typically benign and can happen to anyone, especially in response to stress, caffeine, or fatigue. However, if you consistently notice this sensation or if it is accompanied by other symptoms (like dizziness, chest pain, or shortness of breath), it is advisable to seek medical evaluation.

2. Potential Health Implications of Skipped Beats: While occasional skipped beats (premature atrial contractions or premature ventricular contractions) are generally harmless, frequent occurrences can sometimes indicate underlying heart issues, especially if they are associated with symptoms. In some cases, they may lead to more serious arrhythmias or could be a sign of heart disease. If you experience significant changes in your heartbeat, it is crucial to consult a healthcare provider who may recommend further evaluation, such as an electrocardiogram (ECG) or a Holter monitor, to assess your heart's rhythm over a more extended period.

3. Normal vs. Abnormal Heartbeat Irregularities: Skipped beats can be a normal occurrence for many people, particularly in response to lifestyle factors such as stress, caffeine intake, or lack of sleep. However, if these irregularities become frequent or if they are accompanied by concerning symptoms, they may indicate a more serious condition that requires medical attention. Factors that can lead to heartbeat irregularities include electrolyte imbalances, hormonal changes, heart disease, and certain medications.

In summary, while what you are experiencing may be a normal variation in heart rhythm, it is essential to monitor your symptoms closely. If you notice a pattern of irregularities or if they are accompanied by other symptoms, it would be prudent to consult with a healthcare professional. They can provide a thorough evaluation and determine if any further testing or intervention is necessary. Remember, your heart health is paramount, and being proactive about any changes you notice is always a wise approach.

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