Stellenbosch University
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Does your heart skip a beat?
Author: Dr. Jo-Anne Kirby
Published: 11/06/2020

Sometimes it feels like one's heart skips a beat. If this only occurs very rarely, it's nothing to worry about. Your heart is not actually forgetting to beat - there is just a delay before the next beat.

Other times, it can feel like your heart rate is going to fast or too slow for the circumstances that you are currently in. These sensations are referred to as palpitations.

South Africa celebrates World Heart Rhythm week in the first week of June. A heart rhythm problem often presents with recurrent palpitations.

When should you be concerned about palpitations?

  • If, in a space of 10 seconds, you have 3 or more odd beats, or over a minute, it occurs more than 12 times
  • If preceding the sensation, you have recently changed or started new medication
  • If at the time your heart is jumping about, you also feel dizzy or as though you are going to faint
  • If you have any chest pain or pressure or you feel short of breath.


Often, by the time you see the doctor, your heart is behaving perfectly so it's useful to count how fast your heart is beating when it feels fast to you. You can feel at your wrist or next to your Adam's apple and count how many beats you feel in 10 seconds. Multiply this number by 6 to get how many beats your heart takes in 1 minute.

When exercising, it is normal for your heart rate to go up in response to exercise, but sometimes it feels like it's too fast. How do you tell if your heart is beating too fast? Subtract your age in years from 230 and you get your maximum heart rate. For example, if you are 50, your maximum heart rate is 230 – 50 = 180 beats per minute. If you are 20 years old, your maximum heart rate is 210 beats per minute. If your heart rate is faster than this, consult with your doctor.

Before you go and see your doctor, gather some background information. This does not mean asking Dr Google! Take any medicine or herbal supplements that you are taking with you to your appointment. Find out if someone in your family has heart trouble and the name of the diagnosis. Count how many cups of coffee or other caffeine containing foods you eat / drink in a day.

Your doctor will ask some more questions and do a physical examination looking for other causes of the altered heart rate. They will also do an electrocardiogram (ECG) to look at the rhythm of your heart, if it is appropriate. There may also be some finger prick tests and some blood tests needed. Sometimes, your doctor will need you to exercise while the ECG is done. This is known as a stress ECG or effort ECG.

Campus Health Service has the equipment to do an ECG and perform a stress exercise ECG (on an exercise bike). If you are concerned about your health and your heart rhythm, please schedule an appointment. It's great if you can be seen while your heart is playing its tricks, but it is also possible to find out the cause even when it is not acting up!

Please remember to phone for an appointment during lockdown.

Stellenbosch Campus: 021 808 3494/6

Tygerberg Campus: 021 938 9590