DEAR DR. DONOHUE: I am 49, female and in good health. I do not take any medications. Several months ago, I developed an arrhythmia. My pulse would skip anywhere from once every four or five beats to once every 20 beats. I had no other symptoms.
A series of tests -- including an EKG, an echocardiogram and a stress test -- was all normal. My doctor informed me that this was not a concern, since we ruled out heart disease.
My pulse continues to skip beats. Is there anything else I need to do? -- A.P.
ANSWER: Skipped beats are the most common heartbeat abnormality. Everyone has them from time to time. They aren't "skipped" beats; they're premature beats, ones that come before the normal scheduled beat. People don't feel the premature beat. But after it, there is a delay until the next normal heartbeat occurs. During that delay, the heart fills with more blood than usual. When the normal beat arrives, the heart pumps out that extra blood, and the person feels it as a thud in the chest.
So long as premature beats are not associated with any abnormal heart condition, they can be dismissed as not indicating current or future trouble. You have had a thorough heart exam. All your tests were normal. Your doctor feels that any more tests would be unnecessary. That's a valid decision. Worrying about premature beats can be a greater health threat than the beats themselves.
Only if they increase in number or produce symptoms like feeling faint would further testing be of value to you now.
The booklet on heartbeat irregularities discusses the more common and serious kinds of arrhythmias. Readers can order a copy by writing: Dr. Donohue -- No. 107W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient's printed name and address. Please allow four weeks for delivery.
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