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Most heart palpitations are normal. Here are 5 reasons your heart might be skipping a beat.

Your heart may pound when you鈥檙e excited. It might race when you are scared. It might flutter when you fall in love. These odd sensations are called heart palpitations. may feel like your heart is skipping a beat, quivering or pounding for no reason.

鈥淯sually when you experience a skipped heartbeat, it may be an interruption of your regular heart rhythm,鈥� says Andrew Zadeh, MD, a cardiologist with the 喵咪社区 Cardiac and Vascular Institute, part of 喵咪社区. You don鈥檛 usually notice this regular rhythm when your heart is beating normally.

The science behind a skipped heartbeat

鈥淓ach heartbeat is transmitted to the rest of the body as a pulse,鈥� says Dr. Zadeh. 鈥淎 pulse is a force exerted by the internal pressure increase in your artery as blood leaves the heart.鈥�

When the regular heart rhythm is disrupted with an extra beat, though, the force pumping blood from the heart isn鈥檛 timed properly and isn鈥檛 as strong.  

鈥淭his results in a reduced pressure increase and reduced, or sometimes unnoticeable, pulse associated with the extra beat,鈥� Dr. Zadeh says. 鈥淲hen I hear patients say they feel their heart 鈥榮kipping a beat,鈥� it is usually tied to a single premature beat that fails to produce an extra pulse. The 鈥榮kip鈥� is the 鈥榩ulseless鈥� time it takes for the next beat or pulse to come in.鈥�  

Basically, your heart鈥檚 rhythm is off, and you can notice it. medical issues. They鈥檙e just caused by fluctuations in emotion or exertion level. Let鈥檚 examine some of the reasons you may be feeling a skipped heartbeat and talk about when it might be time to see a doctor. 

5 common causes of a skipped heartbeat

1. Anxiety and stress

Although heart palpitations can sometimes be a sign of heart disease, they more frequently have non-heart-related causes. For example, when you鈥檙e nervous or excited, you might feel a fluttering or pounding heartbeat. Mental health issues, such as anxiety or stress, can cause your heart to beat strangely. And in a vicious cycle, having palpitations can also lead to more stress.  

You can take steps at home to reduce stress and anxiety to help stop the feeling of a skipped heartbeat. Breathing exercises and other relaxation techniques may help, such as yoga, meditation or tai chi.  

2. Caffeine, alcohol, nicotine and medications  

What you put in your body also can cause heart palpitations. 

鈥淢any of the patients I see who experience arrhythmia, or skipped heartbeats, can have triggers that increase the frequency of symptoms,鈥� Dr. Zadeh says. Along with anxiety, 鈥渃affeine has traditionally been associated with an increase of symptoms for some people,鈥� he says. 鈥淥thers include alcohol, nicotine and some medications.鈥�  

Medications that may cause palpitations range from over-the-counter decongestants and diet pills to some prescription medications, including those to treat asthma. Illegal drugs, such as cocaine, can also contribute to heart arrhythmia.  

鈥淚dentifying what lifestyle factors influence your symptoms is the first step, and then trying to avoid or reduce them is usually beneficial,鈥� Dr. Zadeh says. 

3. Atrial fibrillation (A-fib) 

An arrhythmia, or a problem with how your heart beats, can cause you to feel like your heart is skipping or fluttering. The most common medical cause of is atrial fibrillation, also known as A-fib, which is also the cardiac cause of heart palpitations. In this condition, the aren鈥檛 properly coordinated, which causes your heart to beat irregularly and fast. 

Older adults and people with high blood pressure, obesity, diabetes or other health problems are more likely to develop A-fib. It鈥檚 important to treat the condition with medication and lifestyle changes, because it can put you at greater risk for stroke. Other atrial fibrillation symptoms to look for include lightheadedness, fatigue, shortness of breath and chest pain. 

4. Heart disease 

Heart palpitations can also be caused by various forms of heart disease involving the heart鈥檚 valves, muscles or arteries. For example, is the most common structural heart problem to cause palpitations. Issues with the heart鈥檚 muscle () and (narrowing of the arteries) can also lead to arrhythmias, causing heart palpitations. 

鈥淗eart disease involving either poor blood flow or valve abnormalities can easily be evaluated through a series of tests including electrocardiogram, echocardiogram or stress testing,鈥� Dr. Zadeh says.  

5. Overactive thyroid 

Too much thyroid hormone can increase your metabolism, making your heart race and causing palpitations. Luckily, it is relatively easy to diagnose an overactive thyroid, which is a condition known as .  

鈥淭hyroid disease can be evaluated with simple blood tests,鈥� Dr. Zadeh says. Medications are available to treat hyperthyroidism. 

Get evaluated by a specialist 

Although frequent heart palpitations may not be serious, it鈥檚 important to be evaluated by a doctor to make sure you don鈥檛 have a condition causing an irregular heartbeat. 鈥淭his evaluation is best done by a cardiologist, who can also detect some of these conditions with a careful history and physical examination,鈥� Dr. Zadeh says. 

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