If your teenager has a “skipped” heartbeat and problems breathing, what might this possibly mean?

A teen may experience what seems like a skipped heartbeat from anxiety, but trouble with breathing adds a whole new dimension to the sensation.

“A teen with these complaints needs to be evaluated for congenital heart disease, abnormalities of heart rhythm and lung disease,” says cardiologist Norman E. Lepor, MD, Co-director, Cardiovascular Imaging, Westside Medical Imaging and Clinical Professor of Medicine at UCLA.

He adds, “Absent these one would consider seeking out psychological causes (stress…) that can be associated with hyperventilation.

“Useful testing in these patients include pulse oximetry, echocardiography, Holter monitor and even treadmill testing to assess exercise tolerance.”

The symptoms can be caused by panic attacks, and panic attacks aren’t always triggered by a definitive stressor. The skipped heartbeat and apparent difficulty or problems with breathing may also have separate causes.

For instance, the issue with breathing can be caused by acid reflux, and yes, teenagers can get acid reflux.

When the acid gets as far up as the vocal cords (and the patient won’t necessarily experience heartburn), this can cause a situation called laryngopharyngeal reflux (LPR).

“Even young healthy people can develop LPR during stressful periods, eating a poor diet, even during exercise,” says Dr. Stacey Silvers, MD, of Madison ENT & Facial Plastic Surgery in NYC, who is board certified in otolaryngology.

“Sudden or gradual voice changes, choking symptoms and shortness of breath are usually symptoms of LPR,” says Dr. Silvers.

The skipped heartbeat could be from fear stemming from the shortness of breath, from general anxiety or from a cardiac issue, even though in a teen, a skipped heartbeat and problems with breathing are more likely to have a non-cardiac origin.

Nevertheless, it’s important to see a cardiologist to see if a cardiac cause can be ruled out.

Having performed over 4,000 coronary angiograms and angioplasties, Dr. Lepor has focused on prevention and treatment of coronary heart disease. 

An NYC expert in ear, nose and throat care, Dr. Silvers has been named among America’s Top Physicians and Surgeons in facial plastic surgery and otolaryngology numerous times since 2003.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.