Understanding abnormal heart palpitations

They may feel like racing, pounding, fluttering, skipping, or an extra beat. Some occur with a normal rhythm made more noticeable by exertion, stress, caffeine, dehydration, fever, or poor sleep; others reflect an abnormal rhythm or another medical problem.

Atrial fibrillation commonly presents with an irregular pulse and palpitations, although some people notice breathlessness or fatigue instead. Hyperthyroidism can present with a fast heartbeat alongside heat intolerance, tremor, sweating, or weight change. Anaemia may present with palpitations, tiredness, pallor, or shortness of breath.

Low blood sugar, dehydration, anxiety symptoms, stimulant medicines, decongestants, nicotine, and energy drinks can also provoke a noticeable heartbeat. The sensation alone cannot reliably distinguish these possibilities.

Note when each episode starts, whether onset is sudden or gradual, how long it lasts, whether the rhythm feels regular, and what stops it. Record associated chest discomfort, breathlessness, dizziness, fainting, sweating, meals, exertion, stress, caffeine, alcohol, and any medicine taken nearby.

A clinician may check your pulse, blood pressure, heart and thyroid examination, obtain an ECG, or order blood tests. Because episodes can be intermittent, a portable rhythm monitor may be more useful than a single resting tracing.

Call emergency services when palpitations occur with fainting, severe breathlessness, marked weakness, or heavy chest pressure or pain. Urgent help is also needed when chest discomfort spreads to the arm, jaw, back, or shoulder or occurs with sweating and nausea.

Arrange prompt assessment if episodes are becoming more frequent, persist unusually long for you, start during exercise, or accompany near-fainting. If symptoms have stopped but included collapse or significant chest pain, they still require medical evaluation.

Ask whether the pulse or ECG showed a rhythm disturbance, whether blood tests are appropriate, and whether a monitor should capture an episode. Check which medicines or stimulants could contribute and what action to take if the sensation returns with new symptoms.