Re: skipping heart
I am late here I know, way too many hours in school and on the truck. If it happens again call an ambulance to transport you to the ER, they will do the blood work right there and probably have you see a cardiologist as a consult while there. If it is an electrolyte imbalance the chance of a fatal dysrhythmia is VERY high. The heart mainly needs calcium, potassium, and sodium to work and has a very small range before it goes haywire. A heart attack is only one of a few ways to die from heart problems, sometime the only indicator of a heart attack is a change in the EKG that shows a Q wave from damaged heart muscle since there are many incidents of silent heart attacks, no chest pain.
You mentioned PVCs, these are usually nothing to be worried about but, can be triggered from a area of the heart muscle that is irritated, eventualy the muscle will be irritated enough that all beats will be PVCs or Ventricular Tachycardia. Technically, according to the american heart association's ACLS course three PVCs in a row is Ventricular Tachycardia, a life threatening dysrhytmia. When you feel that heart skip there is a good chance there is a PVC, or it could be a pre atrial contraction, pre junctional contraction, a sinus block, sinus pause, run of 2nd degree heart block type II, or type I, atrial fibrillation that has bardycardia associated with it. Point is any and all of these dysrhytmias have the potential to kill you and waiting for a family Dr to get off of their ass and "schedule" blood work could kill you. With any of the early contractions of the heart there is usually a compensatory pause, that coupled with the early beat not pumping blood is why you feel a skip. If PVCs become frequent enough or early enough following a regular beat there can be what is called R on T phenomonon which is followed by Ventricular Fibrillation, unless you have a defibrilator that can be applied and used within 4 min you will probably not make it. Another potential problem is a number of fast or "tachy" dysrhythmias that the electrical rates is much faster than the mechanical part of the heart can tolerate. With these you make think your skipping beats but the electrical side is working and the mechanical or muscle is not following along with it.
Most EMS services, if Paramedic level, have 12 lead EKGs on the truck. We sit around and talk about the ones that should have called us earlier and they would be here, do not be that person call an ambulance when you notice something wrong. That 5-10 min it takes an ambulance to arrive makes the odds of suvival very low if you go into cardiac arrest. Almost all of us can diagnose and treat the lethal dysrhythmias and give you a chance. We carry almost all emergency drugs to keep you out of cardiac arrest when a pt experiences a lethal dysrhythmia. The success of cardiac arrest survival is not good statistic at all, most likely if it comes to that your best outcome is living a few weeks on a ventilator while the heart finishes dying. The brain does not like no oxygen for more than a couple of minutes and damage to it is irreversable.
There are so many variables and so many things that have to function properly for the heart to pump blood that it is imposible to begin to say this or that could be causing your problem. I will tell you what I tell all my patients that want to refuse service or transport, PUTTING THIS OFF MAY KILL YOU.
I felt a little guilty...My sacrifice was small...I only lost a little time...But these men lost their all...Unknown