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Forum Name: Cardiology Symptoms

Question: Missed heart beat


 Carnix - Thu Nov 12, 2009 12:49 pm

For several months now, maybe as long as a year, off and on, I have been experiencing what I can only described as a missed heart beat in the evening. I thought it was mearly heart burn, perhaps GERD -- an esophogeal spasm -- because until last night I wasn't able to detect any particular change in my heart beat when one of the spasms occured. However, last night, while in bed, I was having a particularly significant time of this, and had my finger to my neck and noticed very clearly that my normal "beat beat beat" pulse was broken up in a "beat beat ..... BEAT beat beat" sort of rhythm (if that makes any sense... hard to describe in plain text) with the heavy spasm feeling being the larger then usual "catchup" beat if you will.

There is no pain, although sometimes I do feel heartburn-like symptoms in the middle of my chest or lower left area around the solar plexis area. When the spasm (miss beat) occurs, it sometimes takes my breath away and induces a light cough (not a fit, just one or two very light coughs).

Recently I had a severe reaction to an accidental ingestion of shrimp (I have an allergy to iodine) -- this was only a month or two ago -- and my heartbeat and blood pressure was excellent (don't remember what it was, but the nurse said it was very good when I asked since I didn't know what the numbers actually meant...)

After last night, I intend to seek medical attention, but in searching online I came across this forum and thought I'd ask.

Thanks
 John Kenyon, CNA - Fri Nov 27, 2009 11:45 pm

User avatar Hello -- I think I can help here. What you describe (an actually very good description) is a premature heartbeat, either premature ventricular contraction (PVC) or premature atrial contraction (PAC). The difference is one originates in the atria, the top two chambers of the heart; the other (PVC) originates in the lower chambers. They can feel very similar otherwise. They are extremely common, more so among anxious people, but occur normally in the healthy population as well (of course) as those with some variety of heart disease. They are of no diagnostic nor prognostic significance, but can be very disturbing. Your description is perfect. The next regular heartbeat comes a little early and, in the case of PVCs, there is a compensatory pause so the next beat comes right when it would have normally. Sometimes this makes for a harder subsequent beat, or sometimes the premature beat feels like the more forceful one, depending on the timing. PACs do much the same thing, but the pause afterward is not precisely compensatory and can be shorter or longer. Still no big deal. The sense of having one's breath taken away and the occasional singular cough are caused when one of these beats occurs out of synchrony with the opening and closing of the valves, particularly the tricuspid (pulmonary) valve. Since the blood bound for the lungs has no place else to go, it backs up in the jugular (especially on the right side) and the beat is more forceful, may be felt in the neck and sometimes momentarily seems to snatch the breath. It is only momentary however. These premature beats, especially PVCs, happen quite often when trying to fall asleep, as they are more likely to slip in when the heart is slowing, which it does as we become sleepy or relaxed -- or after exercise, during cooldown/slowdown. They are more readily felt when lying on one's left side and sometimes this can even provoke them, since in some people it brings the apex of the heart into contact with the chest wall, and the heart does not like to to "touched."

All of this is merely by way of explanation of something more common -- and less significant -- than sneezing or hiccups. We all have them. Some of us notice every one, others never feel them. Anxiety over them, ironically, will cause them to become more frequent, so the better one is able to overlook them, the less frequent they may actually become.

It's as simple as that!

Hope this helps. Good luck to you.
 Carnix - Sat Nov 28, 2009 5:50 pm

Thank you for the reassurance! I have a doctor's appointment soon and will definitely bring this along to discuss. I do tend to sleep on my left side, interestingly enough. One additional thing of concern is that I checked my blood pressure the other day and it was 196 over 90 -- which is clearly high. But, I was traveling and my job is somewhat stressful, so it could be that. It sounds like what I'm asking about is a very common question, so if it's OK, I'll post what I find out for everyone's benefit.
 John Kenyon, CNA - Tue Dec 08, 2009 11:56 am

User avatar You're very welcome. I'm glad you have an upcoming appointment, mainly due to that high BP reading. Some people only have it spike during stressful moments, but if the stress is chronic that still can mean elevated BP a good deal of the time, so that's something you may want to follow to get a better idea of how it behaves during the course of a normal day or at relaxed times.

By all means do post any followup findings here, as well as any additional thoughts, questions, etc. Lots of people read here and may pick up useful information this way. We encourage it.

Stay in touch.

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