The sensation of a heart feeling “bubbly,” “fluttering,” or like it has “skipped a beat” is a common experience that often prompts people to seek answers. This feeling is an abnormal awareness of your heartbeat, which can range from benign and temporary to a sign of an underlying medical condition. Understanding the mechanics and potential causes behind this irregular feeling can help clarify the experience.
Understanding the “Bubbly” Sensation
The feeling of a “bubbly” or “skipped” beat is the perception of a premature contraction within the heart. This occurs when an electrical impulse fires earlier than expected, interrupting the heart’s normal rhythm. These premature beats are categorized as either Premature Ventricular Contractions (PVCs), originating in the lower chambers, or Premature Atrial Contractions (PACs), originating in the upper chambers.
The noticeable “bubbly” or “thump” sensation is not the premature beat itself, but the beat that immediately follows it. Since the premature beat occurs too early, the chambers do not fully fill with blood, resulting in an ineffective pump. The heart then pauses briefly to reset its electrical timing, allowing the chambers to fill more fully than usual. The subsequent normal beat is stronger and more forceful, which is the noticeable “thump” or flutter felt in the chest. For most people, these isolated premature beats are infrequent and benign.
Common Lifestyle Triggers
Many instances of this fluttering feeling are triggered by external factors that temporarily increase the heart’s electrical excitability rather than by disease.
Stress and Stimulants
High levels of psychological stress or anxiety flood the bloodstream with adrenaline, a catecholamine hormone that stimulates the heart muscle. This surge makes the heart tissue more sensitive to irregular electrical firing. Consumption of stimulants like excessive caffeine or nicotine can similarly disrupt the heart’s normal electrical pathways. These substances directly increase the heart rate and force of contraction, making the heart more prone to premature beats.
Physical and Hormonal Factors
Even minor imbalances, such as dehydration or low levels of electrolytes like potassium and magnesium, can destabilize heart muscle cells and contribute to the sensation. Poor sleep and intense physical activity are also significant triggers. During intense exercise or recovery, high adrenaline levels combined with fluctuating vagal tone can create an environment where these extra beats occur more frequently. Hormonal shifts, particularly those experienced during the menstrual cycle, pregnancy, or menopause, can alter the body’s balance and contribute to temporary episodes of heart fluttering.
Potential Underlying Medical Causes
While many cases are benign, the sensation can manifest complex underlying medical conditions requiring specialized attention.
Arrhythmias and Systemic Issues
Sustained or frequent rhythm issues, known as arrhythmias, can cause this feeling, such as Atrial Fibrillation (AFib) or Supraventricular Tachycardia (SVT). AFib involves a chaotic, rapid quivering in the heart’s upper chambers, while SVT is a rapid heart rate that starts above the lower chambers. Systemic issues originating outside the heart can also drive these sensations. An overactive thyroid gland (hyperthyroidism) produces excessive thyroid hormone, accelerating the body’s metabolism. This overdrive increases heart rate and force of contraction, making the heart susceptible to irregular rhythms. Anemia, marked by a low red blood cell count, forces the heart to pump harder and faster to deliver adequate oxygen, which may be perceived as fluttering.
Non-Cardiac and Structural Causes
The fluttering feeling is not always cardiac in origin; sometimes, it is a non-cardiac chest sensation that mimics a heart issue. Gastrointestinal problems like severe acid reflux (GERD) can irritate the esophagus, which lies in close proximity to the heart. This irritation can stimulate the vagus nerve, a major nerve connecting the brain, heart, and digestive system, mistakenly triggering an irregular rhythm or fast heartbeat. Structural heart issues, such as heart valve problems or cardiomyopathy, can also compromise the heart’s electrical stability and lead to frequent rhythm disturbances.
Critical Symptoms Requiring Medical Evaluation
Infrequent or isolated episodes are rarely a concern, but certain accompanying symptoms require medical investigation. A fluttering sensation occurring alongside chest pain, pressure, or tightness may indicate a serious cardiac event. If the bubbly feeling is paired with severe shortness of breath, dizziness, or a feeling of lightheadedness, a medical evaluation is necessary. A sudden loss of consciousness or fainting (syncope) combined with an irregular heartbeat is a red flag that warrants immediate emergency medical care.
A healthcare provider typically begins the investigation with an Electrocardiogram (ECG or EKG) to measure the heart’s electrical activity in real time. If episodes are intermittent, a portable monitor like a Holter monitor may be worn for 24 to 48 hours to record the heart’s rhythm during daily activities, helping to correlate symptoms with any electrical irregularities.