Abnormal beating of the heart can be caused by many factors, with varying levels of concern

You may have noticed it as a pounding sensation in your chest, a flurry of heart activity. Or you might have felt the quite literal example of a skipped beat. It’s possible you didn’t feel anything at all, but your heart had a hiccup of some kind without you noticing.

Any way it happens, a missed or erratic beat, known as a heart arrhythmia, can be alarming. It’s the heart we’re talking about, after all. But not all arrhythmia episodes are the same. Knowing what you’re up against can help you find both peace of mind or the solutions to ensure a healthier heart.

There’s a long list of reasons your heart might beat fast or irregularly for a moment. To understand why, it helps to know a bit about what the heart does when working as intended. Your heart takes cues from your brain via electric impulses that tell it to keep pumping. If for some reason the electrical current is interrupted or altered, it causes the heart to respond in kind. A common kind of arrhythmia is a palpitation, which is marked by an accelerated heartbeat or “flutter” that is often felt in the chest or neck.

There are dozens of things that might contribute to a palpitation episode. Stress, caffeine intake and medications all can serve as a trigger for an event. But those items are only the triggering mechanisms, so additional research might be required to diagnose the underlying cause.

“These kinds of triggers are not the cause. They are making them more noticeable,” says Dr. Ayman Hussein, a cardiologist and heart rhythm specialist for the Cleveland Clinic.

How thoroughly concerned you should be about a skipped beat depends on many factors, including their frequency, the accompanying symptoms and your age.

If you have one skipped beat, and then the situation goes away, you should call your general practitioner about the event and make an appointment, Hussein says, but there probably isn’t a need to rush to the emergency room. If the situation is accompanied by extreme shortness of breath or noticeable fatigue, your symptoms should be investigated urgently.

A number of conditions can cause arrhythmia. Some people are born with extra electrical conductors in their heart, creating a short circuit from time to time. Stress as a contributing factor is more common in younger patients. Meanwhile, atrial fibrillation, a condition during which the upper chambers of the heart flutter, is more common among those 60 and above. Atrial fibrillation increases the risk of stroke in both men and women. There are several conditions including congestive heart failure, hypertension, age and diabetes that increase your risk of stroke when you have atrial fibrillation.

Typically, heart monitors used either in a doctor’s office or worn during daily activities are used to help isolate the cause.

“We try to find the correlation between the symptoms and the irregularity,” Hussein says.

Depending on the results, many treatment options may be recommended. A truly isolated incident might not require treatment at all. Or, if stress is triggering the palpitations, it’s the stress that needs to be eliminated. Those with atrial fibrillation might need to take blood thinners to help prevent the kind of blood vessel blockages that cause strokes. For more serious or persistent types of arrhythmia, a procedure called an ablation might be done to reset the timing of your heartbeats.

No matter the condition, it’s always good to be thinking of your heart. Knowing about arrhythmia and its causes can help the beat go on.

Listen to your body. See your doctor if you notice symptoms of arrhythmia.

What causes heart palpitations?

Heart palpitations may be caused by:

  • Emotions, such as anxiety, stress, fear, panic
  • Exercise
  • Pregnancy
  • Caffeine found in many beverages and foods
  • Certain medical conditions, including fever, anemia or shock
  • Certain medications, including asthma inhalers, thyroid medications and some over-the-counter medications that act as stimulants, such as cough and cold medicines
  • Nicotine

Source: Cleveland Clinic