
What Causes Skipped Heart Beats With Normal EKG?

Very likely to be harmless! / get examined & investigated
Detailed Answer:
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Feeling of ‘dropping- skipping- missed- hard- fluttering-’ beat is called ECTOPIC or premature beats. A beat comes earlier than normal – this itself is not usually felt. The next beat is a bit delayed - longer time to recover from early extra beat – so heart fills more and the beat appears forcible – thud / lubb - - dubb - - lubb - - dubb - lub - - - DUBB /
Ectopic beats can arise from ventricle (lower chamber of the heart - Ventricular Ectopic; VPC) or Atrium (upper chamber - Atrial Ectopic; APC). APCs are generally harmless. Even VPCs are often harmless – ‘benign’. If they are frequent - more than 5 per hour, 2 or more beats coming consecutively – they should be investigated further.
The first step is to see a Cardiologist.
A thorough history and physical examination is the first step -
ECG (Electrocardiogram / EKG) – Routine 12-lead – is part of clinical examination.
ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality) / clots...
Irregular heartbeats need to be DOCUMENTED by ElectroCardioGram (EKG). Standard ECG records the electrical activity of the heart, for a few seconds. It can detect the arrhythmia occurring during that time only. If the episode occurs randomly or is precipitated by a specific activity like exercise - one needs Holter or event monitor. Holter records for days; Event Monitor for weeks… Holter records continuously; Event Monitor only at certain times
Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much tea, coffee, cola) / Fever / Infection / Pain / Stress / Thyroid / calcium, magnesium / Medicines like Phenylephrine used for ‘cold’; Salbutamol used for asthma and so on - may be responsible.... / rarely, abnormal nerve paths in the heart (bypass tracts) or disease of the conduction system may be responsible!
Many cases of palpitation are benign, especially when associated with normal ECHO and may not require treatment, If you also have symptoms like blurred vision, dizziness, loss of consciousness, shortness of breath, chest pain along with this, you need urgent work up
Good luck
God bless you

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