Extra Heart Beats/Skipping beats

  Dear Doctor,
  I am a 44 year old male non-smoker and I am not overweight. Approximately 7 years ago during a business trip I experienced a significant missed, or hard heart beat that took my breath away. Following that occurrence my family doctor ordered a echo cardiagram and I was diagnosed with mitrol-valve prolapse. As a result of it not being serious I was not given any type of heart medication, although to releive my anxieties I was given a low does prescription of Xanax. Over the past 7 years I have had episodes where I again experience a fluttering feeling of missed heartbeat but these have been single episodes and do not continue. I have undergone additional echo testing as well as treadmill stress testing because of a history of heart problems in my family. I have passed all stress tests and been told that other than being out of shape and anxious I was Ok. Approximatley 3 years ago a new cardiologist told me that I did not have the classic mitrol valve prolapse problem but two of my heart valves had minimal leakage.
  My current problems began over the past weekend, instead of having individual skipped or missing heart beat occurences, I am experiencing continual skipping approximately, every two to three minutes, no matter what I am doing. I have spoken to my family doctor and he told me there is nothing to be concerned about and that it is a benign condition. He suggested that if I wanted to, he could prescribe a low dosage, once a day beta blocker prescription to releive the symtoms (symptoms) I am experiencing. He also said this drug could be used only when I am experiencing problems and not on a regular basis. I have a real problem in starting to take heart medication at my age, especially when I hear the problems some men experience with this type of drug. Is there an alternative to drug therapy for this condition? Will the problem I am experiencing now, go away on its own? Should I be seeing another doctor or have different types of testing done? HOW CONCERNED SHOULD I BE???? Additional information you should no of about me, I am President of a very successful company and I work six or seven days a week on a regular basis. I exercise very little and have a concern now with pushing myself to far. I appreciate your timely response to my questions. Thank You.            
              

[CCF Cardio MD - MTR]

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Dear McGee, thank you for your question.  As you can see by the response your question has generated, palpitations are a common disorder.  Premature beats of the atria and ventricles occur frequently in the general population and most people don't notice when they are having premature beats.  However, if you had a normal echo (minimal leakage of the valves is considered a normal variant) and a normal stress test, then you have a normal heart.  Thus, premature beats that cause you to have fluttering or palpitations are benign meaning they will not harm you.  However, as you write, these palpitations are a nuisance.  After a premature beat, the heart rhythm resets so a pause ensues before the next beat and a heartbeat is not "skipped."   Common precipitants of premature beats are alcohol, tobacco, and caffeine so those should be avoided.  If you are still having premature beats after this, then you could take a beta blocker to suppress the premature beats, or you could try to develop a mechanism to cope with the palpitations.   Additionally, I recommend that you start a daily exercise program which would help to relieve stress and may reduce the frequency of your palpitations.

I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.  Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart
Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.