Extra or premature heartbeat
Health and lifestyle FAQs
View our short videos specifically designed to answer all your questions about how your health and lifestyle affect your heart health.
Extra or premature heartbeats can feel strange, like your heart skipping a beat or fluttering in your chest. We often experience these types of heartbeats when we are stressed or lacking in sleep. However, they can be a sign of something more serious.
What are extra or premature heartbeats?
Extra heartbeats occur before the next beat, throwing off your heart’s natural rhythm. They can make your heart feel as though it skipped a beat or is fluttering in your chest.
These extra beats can either occur in one of the ventricles (lower chamber of the heart) or one of the atria (upper chamber of the heart). If they occur in the ventricles, they are called premature ventricular contractions (PVCs). If they occur in the atria, they are called premature atrial contractions (PACs).
Symptoms
Depending on the part of your heart where the extra beat has occurred, you may not experience any signs of heart issues at all.
You may experience the following symptoms:
- Fatigue
- Pounding feeling in the neck
- Palpitations
- Feeling that the heart has beat an extra time
- Dizziness
- Anxiety
- Difficulty breathing
Emergency care
Most people experience extra heartbeats from time to time, often without noticing them. Typically, PVCs and PACs aren’t concerning on their own and should disappear with changes to your lifestyle, such as reducing your caffeine intake.
However, PVCs and PACs can become concerning if you start having other cardiac symptoms, too. We advise you to seek emergency medical assistance if you experience the following:
- Iregular heart rate
- You’re experiencing shortness of breath (dyspnea)
- You’ve fainted (syncope) or lost consciousness, even if only briefly
- Pain or a feeling of pressure in your chest
- Sweating, clammy, or suddenly feeling chilly for no apparent reason
- Feeling confused, lightheaded, or dizzy
- Feeling extremely weak
- Sudden pain in your belly, arm, shoulder, neck, jaw, or teeth
Causes
It is difficult to determine the cause of PACs or PVCs, as they frequently occur in healthy individuals.
Lifestyle factors can cause extra heartbeats. These include:
- High caffeine consumption
- High anxiety levels
- Sleep deprivation
- High levels of stress hormones such as adrenaline, norepinephrine, or dopamine
- Smoking
- Alcohol consumption
- Illegal drug usage
Some heart conditions can cause changes to your heartbeats, such as:
- Injury to the heart
- Coronary artery disease
- Heart failure
- Hypertrophic cardiomyopathy
- Heart valve disease, including mitral valve disease
- Atrial septal defect
- Mitral valve prolapse
- Heart attack
Medical conditions separate from the heart can also cause irregular heartbeats. These include:
Side effects caused by certain medications
- Abnormal electrolyte levels (low magnesium, low potassium, or high calcium levels)
- Anaemia
- High blood pressure
- Low oxygen levels
- Overactive thyroid (hyperthyroidism)
Diagnosis
To diagnose premature heartbeats, your doctor will need to review your medical and family history as well as your current symptoms. They may also need to perform a physical exam to check your heart and any other abnormalities that may be present.
If there are any signs of concern, your doctor may suggest you have further diagnostic tests to pinpoint the issue. This may include an electrocardiogram to monitor your heart’s activity.
We may ask you to wear a Holter monitor to assess your heart’s electrical activity over 24 to 48 hours. The findings collected over a two-day period are more likely to pick up evidence of premature heartbeats than an electrocardiogram.
If we need to assess your heart’s activity for a longer period of time, we may ask you to wear an event monitor. This device is almost identical to a Holter monitor, but it doesn’t continuously track your heart. Instead, an event monitor will track your heart only when you experience symptoms such as palpitations.
We may also send you for other tests such as blood tests, an echocardiogram (an ultrasound scan of the heart), or a stress test.
Treatment
Your doctor may suggest some lifestyle changes or changes to your medication (if you’re taking prescribed medication) to help elevate your symptoms. This can include limiting caffeine, tobacco and alcohol and stress.
Check out these articles to learn more about some lifestyle changes you can make to improve your heart health:
- How to keep your heart healthy
- How to calm your anxious heart
- How dangerous is stress for our heart health
If symptoms are frequent, we may prescribe medication to manage them. These may include beta blockers, anti-arrhythmic drugs, or calcium channel blockers. These medications help to reduce blood pressure or lower your heart rate so you can experience fewer episodes of PVCs or PACs.
If you cannot take medication, no longer wish to take medication long-term, or have severe symptoms, we may recommend catheter ablation. This procedure involves using radiofrequency energy to destroy the area of heart tissue causing the irregular contractions.
You can read more about catheter ablation in our blog, ‘What is cardiac ablation? Purpose, procedure, and recovery.’
Book an appointment
Having a frequently fluttering heart can be worrying and stressful.
Our private cardiologist and heart rhythm specialist will carefully evaluate your symptoms. After a thorough diagnostic service, we will provide a tailored treatment plan tailored to your needs and preferences.
Don’t ignore your symptoms, and book an appointment today.
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