Heart skipping a beat: why it happens, when it is dangerous and why checking your pulse fuels anxiety. Read practical ways to cope with this common worry.
You are sitting on the sofa in the evening watching television when you feel a brief emptiness in your chest; the heart seems to stop for a moment, then restarts with a strong beat. It lasts a second or two, but from that moment on the rest of the evening changes. Your fingers go to your wrist, you count your pulse, you wait to see whether there will be another skip. When you get into bed you can't turn onto your left side, because you hear your heartbeat more clearly in that position. The feeling of your heart skipping a beat is a very familiar visitor both to cardiology clinics and to therapy rooms. In this article I deal briefly with the physical side of this sensation and in more detail with its relationship to anxiety. It is important to start with a warning: the first port of call for any new or changing heart complaint is a cardiologist or your GP. This article does not replace that assessment; it focuses on how to live with anxiety once the assessment has been made.
What Is the Feeling of Your Heart Skipping a Beat?
This sensation, described in everyday language with expressions such as "my heart is skipping", "my heart jumped", "it feels like it stops for a moment" or "something is somersaulting in my chest", is in medicine most often related to early beats. During the heart's normal rhythm, one beat comes slightly earlier than expected. The heart then pauses briefly, and the next beat is felt more strongly because the chambers have filled with more blood. What the person perceives as "it stopped" is this brief pause, and what they feel as a "thump" is the strong beat that follows.
Such early beats are common in healthy people too. Most people never notice them; some feel them very distinctly. Feeling them does not mean the beats are more dangerous. Some people are more sensitive to bodily sensations, and in some periods our attention is drawn more towards the body.
That said, early beats can also be seen in some heart diseases, thyroid problems, anaemia, electrolyte imbalances or as an effect of some medications. That is why, when you experience it for the first time or when its frequency changes, a doctor needs to make this distinction. If they consider it necessary, your doctor may request an electrocardiogram, a Holter monitor that records your rhythm throughout the day, or blood tests.
Why Does Your Heart Skip a Beat?
Some of the factors that can increase early beats and make the skipping sensation more noticeable relate to everyday life:
- Stress and anxiety: Stress hormones can increase the electrical excitability of the heart.
- Caffeine: Too much tea, coffee and energy drinks increase skipped beats in some people. Let's not forget that in Turkey eight or ten glasses of tea a day are considered "nothing".
- Lack of sleep and fatigue: Short and broken sleep raises the body's level of alarm.
- Smoking and alcohol: The skipping sensation may increase especially on the day after heavy drinking.
- Heavy meals and bloating: Some people notice skipped beats more after large meals or when their stomach is bloated.
- Inactivity and moments of rest: Interestingly, many people feel skipped beats most when resting in the evening or lying down in bed. One reason for this is that the stimuli which distract attention during the day decrease and the body's voice becomes more audible.
How does anxiety magnify skipped beats?
Anxiety has two roles here. First, anxiety and stress can genuinely increase skipped beats in the body. Second, and perhaps more importantly, anxiety changes the attention and meaning given to the skip. A person without anxiety feels a skip and forgets it. An anxious person, however, interprets the skip as a sign of danger: "My heart is going to stop", "This is the start of a heart attack." This interpretation raises fear, fear speeds up the heartbeat, the faster heart and increased adrenaline produce new sensations, and the person sees these as new evidence too. For more information on the relationship between palpitations and stress, you can read the article on heart palpitations and stress.
The Anxiety of a Skipping Heart: The Pulse-Checking Cycle
A common pattern is seen in most people who struggle with the feeling of their heart skipping a beat even though their test results are clear: checking. Putting a finger on the wrist or neck and counting the pulse many times a day, putting a hand on the chest and listening to the rhythm, monitoring the heart while climbing stairs, using a home blood pressure monitor just for the pulse.
Checking brings relief for a moment: "Fine, it's beating." But this relief is short-lived. Moreover, every check locks attention onto the heart a little more. Someone listening to their heart starts to hear normal rhythm changes they had never noticed before. Even an entirely ordinary fluctuation, such as the heart speeding up slightly on the in-breath and slowing down on the out-breath, starts to look suspicious.
Let's consider an example: you are a thirty-eight-year-old sales manager with a fast-paced job. You felt the first skip during a client meeting, went to cardiology, wore a Holter monitor, and in the end were told "harmless early beats". You were relieved, but a few weeks later there was another skip and the thought came to mind: "What if the bad one wasn't caught on the day of the recording?" Now you take your pulse every evening before bed, you hesitate to go for a run at the weekend, and although you have given up coffee completely you carry a restlessness inside. This picture is the cycle not of the heart, but of anxiety.
Avoidance is part of the cycle too
Over time, many people who fear skipped beats avoid stairs, give up exercise, won't go into a Turkish bath or sauna, and even stay away from watching an exciting match. These avoidances make you feel safe in the short term; in the long term, however, they narrow life and strengthen the belief "my heart is weak, I must protect it". As fitness drops, the heart starts to beat faster when climbing stairs, and this feeds the fear again.
Heart Anxiety in Turkey: Stories in the Family
Some heart-related anxieties are fed by family stories. Sentences such as "Grandad died of his heart at exactly this age" or "My uncle didn't wake up one morning" feature in many of our family conversations. For someone whose family has experienced an early heart-related loss, every skip can feel like that story starting again.
On top of this, the "sudden heart attack at a young age" stories frequently encountered on social media and in the news also increase anxiety. These are real and sad events; but the anxious mind applies them directly to its own body, without any statistical context. Someone who watches footage of a footballer collapsing on the pitch may listen to their own heart for hours that night. This shows not that the person is exaggerating, but how quickly the mind applies threat information to itself.
Then there is the matter of emergency departments. In Turkey, emergency departments are relatively easy to access, and many people go to A&E on a night when they are frightened by skipped beats to have an ECG. When there is genuine suspicion, this is an entirely correct step. But if you go to A&E several times in the same week, get the answer "there's nothing wrong" each time and the anxiety returns each time, then what really needs to be addressed is the anxiety itself.
What Can You Do to Cope with Your Heart Skipping a Beat?
The suggestions below are for people who have been assessed by their doctor and in whom a serious heart problem has been ruled out.
Reduce checking in a planned way
For a few days, note how many times a day you check your pulse. Then aim to reduce this number a little each week. When the urge to check comes, try waiting ten minutes. Very often the urge fades without you doing anything.
Describe the skip instead of interpreting it
When you feel a skip, you can say to yourself: "That was an early beat. My doctor said these are harmless. Feeling it doesn't mean it's dangerous." Use these sentences not like something memorised, but as a reminder based on your own experience.
Bring your attention back from the body to the world
If you notice skipped beats more in the evenings and in bed, activities that direct your attention outwards can help at these times: a conversation, an audiobook, a piece of handicraft or noticing the sounds in the room one by one. The aim is not to suppress the skip, but to stop attention locking entirely onto it.
Don't avoid movement
If your doctor has given you the go-ahead, regular walking and exercise increase both your fitness and your trust in your body. Experiencing that a faster heartbeat is not a danger but a healthy response is one of the most powerful antidotes to anxiety.
Review your caffeine intake, but don't turn it into a ritual
Bringing your tea and coffee consumption down to a reasonable level may reduce skipped beats. But wondering with every sip "will this set it off?" can turn your intake into a new area of anxiety. It is better to set a balanced amount and not dwell on it.
Slow your breathing
When fear rises after a skip, the breath is often held or speeds up. This can create tightness in the chest and a new sensation of palpitations. Breathing in through your nose for a count of four and out for a count of six lowers the body's alarm level within a few minutes. Doing this exercise a few times a day, not only in fearful moments but also in calm ones, makes the skill available when you need it. The aim here is not to stop the skip, but to shrink the wave of fear that follows it.
Notice reassurance-seeking
Frequently asking your partner, "Do you think my heart is normal?" or your mother, "Does yours skip too?", or searching forums for similar experiences, brings short-term relief but feeds the cycle. When you notice these questions, you can say to yourself, "That's my anxiety asking right now."
When Should You Seek Professional Support?
First, the medical side. In the following situations, call 112 (emergency services) without waiting or go to an emergency department:
- If the skipping sensation is accompanied by chest pain, shortness of breath, fainting or feeling faint,
- If fast and irregular beats continue for a long time,
- If you experience serious palpitations and feel unwell during exercise.
If there is a history of sudden death at a young age in your family, if you have a known heart condition, or if you have noticed a marked increase in how often the skips occur, cardiology follow-up is important.
If your anxiety persists even though your medical assessment is clear, it may be helpful to see a mental health professional. You may consider getting support particularly if you check your pulse frequently during the day, avoid exercise and everyday activities, go to A&E often or experience sudden waves of fear. If you have sudden and intense attacks of fear, the article on panic attack symptoms may also guide you.
How Is Anxiety About Your Heart Skipping a Beat Addressed in Therapy?
Cognitive behavioural therapy is a frequently used, research-supported approach for heart-related anxiety. The first step in therapy is to draw the person's cycle together: which sensation, which thought, which emotion and which behaviour. Most people feel relieved when they see this map for the first time, because they realise that what they are experiencing is not a random fear but an understandable pattern.
Catastrophic interpretations are then examined. The evidence for the thought "If my heart is skipping, it's going to stop", how many skips the person has experienced so far and what their consequences were are evaluated together. Checking and avoidance behaviours are reduced step by step. With the doctor's approval, exercises that deliberately speed up the heart are done, and the person relearns how to encounter bodily sensations without fear. This approach aims, over time, to calm anxiety's false alarms about the body.
Listening to your heart every moment does not protect it; learning to trust it again, however, gives you your life back.
In some people, behind heart anxiety lies a loss, a sudden death in the family or stress that has long been suppressed. These layers are also taken into account in therapy. You can find more information about work on anxiety and panic on the anxiety and panic page.
Frequently Asked Questions
Is the feeling of your heart skipping a beat dangerous?
It is most often related to early beats and is common in healthy people too. However, only a doctor can make this distinction. If you are experiencing it for the first time or its frequency has changed, a cardiology assessment is important.
Why do I feel it most when lying down?
When you lie down, the stimuli around you decrease and attention turns to the body. Also, when you lie on your left side, the heart is closer to the chest wall, so the beats may be felt more distinctly. This does not mean that skips at night are more dangerous.
My Holter came back clear but I'm still scared. Is that normal?
Yes, this is a very common situation. Anxiety is prone to producing new doubts such as "what if they missed it". Rather than repeating tests again and again, it is usually more helpful to address this cycle of doubt together with a professional.
Will the skipped beats never go away?
The frequency of early beats can change over time and fluctuate with factors such as stress, sleep and caffeine. The aim of therapy is not to eliminate skipped beats completely, but to shrink the meaning you give them and the place they occupy in your life. If anxiety about your heart is narrowing your life, I would like you to know that you can get support to step out of this cycle together.
Bu yazı genel bilgilendirme amaçlıdır; tanı veya tedavi yerine geçmez. Yaşadığınız güçlükler için bir ruh sağlığı uzmanına başvurmanız önerilir. Acil bir durumda lütfen 112'yi arayın.
Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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