What causes fluttering in heart area with a feeling of skipping heartbeats?
Patient: hi i would like to know what u think about this please. over the last few years i have had a few frightening problems happen then stopped for a year and i thought it had gone but then reoccurred again about 4 months ago let me explain - first started when i was working i went to pick something up and then my heart started to beat really fast and hard for about a minute also couldn’t breath good during the time as started to panic but no chest pain. then if i seemed to cough it would go away this would happen again a few times along a 6 months period but it was always when bending over to pick something. about a year on from that time i had gave up smoking drinking more water trying to eat more healthy as i went hospital many times complaining of dizziness and couldn’t breath good that was the reason I made chances to my life, they did heart monitor test and all seemed ok so the 1 year went on since all the changes and i thought everything was back to normal however about 4 months ago i was driving and bent slightly to grab my steering wheel to pull my self up to get out the car and bang it happen i was so scared and seriously thought i was going to die. i then coughed and tried to stay carm and it went back to normal after about 30 secs. huge fast beats pounding feeling dizzy slightly and i panic. NO PAIN during the times i am trying to figure my self what the hell is wrong i tried to cut out caffeine and increase water intake as i said not smoking or drinking and eating healthier food i was just so disappointed it came back after all this time. but i have noticed now and then i get like a flutter around my side heart area near my ribs and also my pulse seems to flatter on my neck PULSE BUT no pain thou and then last for a min goes back. also when i do get pain in my chest its not at these times but the pain does seem to hurt on pulse beat like heart beat then ok then back every beat to the right hand side but as i said this is on and off between the problems above not during. CAN YOU HELP I AM NOT TO CONCERNED AS ITS BEEN ANOTHER 3 MONTHS AND NOTHING APART FROM THE FLUTTERING WITH IS OK BUT I NOW AND THEM SEEM TO SKIP A BEAT AND THINGS BUT NOT OFTEN WITH THEN CAUSES ME TO COUGH ;-) THAT SEEMS TO BE MY ONLY TRICK BUT SO SCARED THAT IT MAY HAPPEN AGAIN I HONESTLY THOUGHT THAT WAS IT FOR ME I WAS HAVING FLASH BACKS DURING THE TIME OF MY LIFE. ;-( I AM 27 AND SLIM 10ST AND ATHLETIC I EXCERSISE AND DON’T DRIN OR SMOKE AT ALL Doctor: Hello and welcome,Occasional and sudden fast heart beats,  pounding,  dizziness, chest pain that are short in duration are highly suggestive of paroxysmal supraventricular tachycardia (PSVT). The episode of PSVT usually goes away with vagal maneuvers (coughing, deep breathing, muscle tensing or putting your face in ice-cold water). PSVT is an abnormal heart rhythm (arrhythmia) that occurs when a short circuit rhythm develops in the upper chamber of the heart which results in a regular but rapid heartbeat (150-200/min) that starts and stops abruptly. Alcohol, caffeine, anxiety, exercise or sudden movements, bending over may trigger the episode of PSVT. PSVT is diagnosed with continuous heart monitoring (Holter). One time ECG may be normal because the abnormality happens during the episodes. You did great job by avoiding alcohol, caffeine, quitting smoking and eating healthy food.  These are called life style changes which is initial step for the treatment of PSVT. Your episodes are very rare and short in duration therefor additional treatment is not indicated. Try to avoid situation that triggers the episodes (bending over) and use vagal maneuvers when the episode happens. You should seek medical attention if PSVT episode does not go away with vagal maneuvers or the episodes become longer up to few minutes. Also avoid over-the-counter decongestants or herbal medicines that may also trigger the episode.I hope the above information will be helpful for you. Please, feel free to ask me if there is anything else you need to know. Thank you,Malik Amonov MD