Extrasystoles - when the heart stumbles: harmless or in need of treatment?

„Doctor, my heart stops sometimes.“
I hear this concern very often during consultations. This usually refers to so-called Extrasystoles. These are additional heartbeats that feel like stumbling, knocking or a brief pause.

The good news: In most cases, extrasystoles are harmless.
However, it is important to classify and know them correctly, When a clarification makes sense.

What are extrasystoles?

Extrasystoles are premature heartbeats, that occur in addition to the normal heart rhythm and often no sign of heart disease are.

How frequent are extrasystoles?

Extrasystoles are very common:

  • Almost everyone has extrasystoles in the course of their life
  • Many do not even notice them
  • They also occur with perfectly heart-healthy persons on


They often increase temporarily, especially during stress, lack of sleep or infections.

What do extrasystoles feel like?

The perception is slightly different for each person. Typical descriptions are

  • Heart stumbling or palpitations
  • Brief „suspension“ of the heartbeat
  • Feeling of anxiety
  • Occasional dizziness or restlessness


For those affected, the Worrying about a serious heart condition is more stressful than the extrasystoles themselves.

Common causes of extrasystoles

Extrasystoles can have various triggers:

Heart-related causes

  • coronary heart disease
  • structural heart disease
  • Myocarditis


Non-cardiac causes

  • Stress and mental strain
  • Electrolyte disorders (e.g. potassium)
  • Thyroid dysfunction
  • Iron deficiency
  • Infections
  • certain medications

Typical triggers in everyday life

Many sufferers report an increase in:

  • Caffeine
  • Nicotine
  • Alcohol
  • emotional stress
  • Lack of sleep


Recognizing individual triggers is often an important first step.

Why breaks are so important after infections

Extrasystoles after viral infections are often a sign that the body and in particular the heart still needs recovery.

 

Therefore:

  • In the event of new heart palpitations after an infection Sport paused become
  • The heart needs time to fully regenerate
  • A medical check-up is advisable before exercising again


In most cases, the extrasystoles disappear completely after sufficient rest.

How are extrasystoles diagnosed?

Depending on the situation, the following are suitable for clarification:

  • Resting ECG
  • Long-term ECG
  • Exercise ECG
  • Cardiac ultrasound
  • Targeted laboratory tests (thyroid, electrolytes)


Smartwatch ECGs can also detect extrasystoles, but these must be verified by a doctor.

When are extrasystoles harmless?

Extrasystoles are usually considered harmless if:

  • there is no known heart disease
  • they only occur occasionally
  • they disappear at rest or after stress reduction
  • there are no additional warning symptoms

When should you have extrasystoles checked?

A cardiologic examination is advisable in the following cases

  • Known heart disease
  • increasing frequency
  • Complaints such as dizziness, shortness of breath or chest pain
  • Appearance under load
  • Fainting or pronounced reduction in performance

Do extrasystoles need to be treated?

Not every extrasystole requires therapy.

  • Education and reassurance are often sufficient for harmless extrasystoles
  • It is important to treat possible causes
  • Drug therapy can be useful in cases of high psychological stress or relevant findings


The decision is always made on an individual basis.

What those affected can do themselves

A heart-healthy lifestyle can have a positive influence on extrasystoles:

  • Regular exercise
  • Sufficient sleep
  • Stress reduction
  • balanced diet
  • Abstaining from nicotine

Conclusion

Extrasystoles often feel disconcerting, but they are harmless in most cases. Correct classification and targeted clarification of warning signs are crucial.

Education takes away fear and is often the most important part of the treatment.

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Emergency

In the event of sudden chest pain, shortness of breath or other acute symptoms, please call 112 immediately.

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