Seek consult to a cardiologist. Why? Because you have risk factors to a heart disease and these are: 1. you are more than 40 years old 2. family history of heart attack 3. skip beat if it is pathologic ( true skip beats 6 per minute) 4. chest tightness if it is not relieved by any means and the chest discomfort will last more than 30 minutes Skip beats are sometimes non-pathologic(not caused by a heart disease) when they occur 6/min and the occurence is only occasional. Even breathing can cause skip beats in some cases. Smoker can present as skip beats. Asthmatic patient can also have skip beats. But, it doesn t mean they have heart disease. Even athletes can present skip beats. However if the skip beats is a pathologic skip beats as previously defined and it causes discomfort or chest pain, further evaluation of a cardiologist is warranted. I am a professor in the college of medicine