Why Does My Heart Sometimes Skip a Beat or Flutter?

The heart is a vital organ in the human body, often regarded as its engine. Issues arising in this area can have significant consequences. While we cannot consciously perceive our own heartbeat, under certain circumstances, we may feel a sudden, thumping sensation accompanied by discomfort. Understanding the causes of these sensations is crucial. So, what causes the heart to thump sometimes? Let's explore the reasons below.

First, heart palpitations can be described as a sensation of the heartbeat being unusually fast, slow, strong, irregular, or forceful. Various factors can trigger this sensation, including anemia, hyperthyroidism, hypertension, and various heart and lung diseases. Additionally, mental and emotional factors can also contribute to the symptoms of heart palpitations. Sometimes, these palpitations may indicate the presence of premature heartbeats, which are heartbeats that occur earlier than normal and occur consecutively.

Second, let's delve into the causes of heart palpitations:

1. Enhanced Cardiac Contractility: Increased heart contractility can lead to palpitations. These palpitations can be physiological or pathological. Physiological palpitations may occur in healthy individuals during intense physical activity or periods of extreme mental stress. However, they can also be triggered by excessive smoking, alcohol consumption, consumption of strong tea or coffee, or the use of certain medications such as ephedrine, caffeine, aminophylline, adrenergic agents, amphetamine, atropine, and thyroid tablets. The severity of these palpitations often depends on the dosage and individual sensitivity.

2. Ventricular Hypertrophy: Acquired heart diseases such as hypertensive heart disease, rheumatic aortic insufficiency, syphilis, or other causes of aortic insufficiency, and rheumatic mitral insufficiency can lead to ventricular hypertrophy and increased heart contractility, resulting in palpitations. In beriberi heart disease, both the left and right ventricles enlarge, and the symptoms of palpitations are often pronounced and intense.

3. Arrhythmia: Tachycardia, atrial fibrillation, or atrial flutter caused by various reasons, especially when they occur suddenly, can easily trigger palpitations.

4. Bradycardia: Conditions such as high-grade atrioventricular block, atrioventricular junctional rhythm, spontaneous ventricular rhythm, sick sinus syndrome, and excessive vagal excitability can lead to bradycardia, prolonged diastole, and increased ventricular filling, resulting in strong and forceful heart contractions and palpitations. However, palpitations are more commonly experienced during sudden slowdowns in heart rate.

5. Cardiac Arrhythmia: Conditions such as premature contractions (ectopic contractions) and atrial fibrillation can cause palpitations. Occasional premature contractions usually do not cause conscious symptoms, but patients may feel palpitations due to sudden heart contractions and sometimes may experience a sensation of sudden cardiac arrest (compensatory pause).

6. Cardiac Neurosis: Cardiac neurosis is a clinical syndrome caused by dysfunction of the autonomic nervous system. It is more common in young and middle-aged women. Apart from palpitations, patients often experience tachycardia, stabbing or dull pain in the precordial region, dyspnea, and symptoms of neurosis such as headache, dizziness, insomnia, fatigue, and difficulty concentrating. The onset of the disease is often related to mental factors and is often triggered by emotional arousal. Beta-adrenergic receptor reactivity syndrome is a condition caused by dysfunction of the autonomic nervous system. The main symptoms include palpitations, chest tightness, dizziness, and tachycardia, which are similar to the symptoms caused by stimulating the beta-adrenergic receptors of the sympathetic nervous system. Mental stimulation is often the precipitating factor, and the condition is more common in young and middle-aged women.