What should you know about body palpitations?

Palpitations are sensations of a racing, fluttering or pounding heartbeat, and their cause needs context. They may be brief and harmless, but a new, persistent or irregular rhythm should be assessed.

Stress, anxiety, caffeine, nicotine, alcohol, fever, dehydration, poor sleep and some medicines can change how strongly you feel your heartbeat. Anaemia, iron deficiency anaemia, an overactive thyroid, low blood sugar and an abnormal rhythm such as atrial fibrillation are other possibilities. Breathlessness, swelling or reduced exercise tolerance can occur with heart failure and should not be dismissed.

Record what the sensation feels like, how long it lasts, whether it starts and stops suddenly, and what you were doing. A clinician may check your pulse, blood pressure, heart rhythm and blood tests, with monitoring if episodes are intermittent.

Sit down, breathe slowly and avoid strenuous activity while an episode is happening. Drink water if you may be dehydrated, and reduce caffeine, nicotine, alcohol and non-prescribed stimulants. Keep a symptom diary with timing, pulse if you can measure it, triggers and associated symptoms. Do not stop prescribed medicines without medical advice.

Call emergency services for palpitations with chest pain, severe breathlessness, fainting, collapse, marked dizziness or new confusion. Seek prompt medical advice if the rhythm remains fast or irregular, episodes are becoming more frequent, or you have known heart disease, thyroid disease or significant anaemia. A first episode that is sustained or different from your usual pattern also warrants assessment.

Ask whether you need an ECG, blood tests or a wearable monitor, which triggers matter in your case, and what action to take if the sensation returns.