Calming heart palpitations: what can help

Palpitations are an awareness of your heartbeat. You may notice pounding, fluttering, racing or a brief pause, in the chest, throat or neck. Stress, fear, poor sleep, dehydration, fever, caffeine, nicotine and some medicines can trigger them. They can also occur with anaemia, an overactive thyroid, low blood sugar or an abnormal rhythm such as atrial fibrillation. A sensation alone cannot identify its cause.

Stop strenuous activity and sit or lie somewhere safe. Relax your shoulders and breathe in gently through your nose, then breathe out for longer than you breathe in. Sip water if you may be dehydrated. Avoid coffee, energy drinks, nicotine, alcohol and decongestants until the episode has passed. Note when it began, how long it lasted, what you were doing and any other symptoms. Do not take someone else’s heart medicine.

Call emergency services if palpitations come with chest pain, severe breathlessness, fainting, marked dizziness, confusion or new weakness. Seek urgent assessment if the heartbeat remains very fast or irregular, or if episodes keep returning. Arrange a GP appointment when palpitations are new, becoming more frequent, or occur with fatigue, weight change or swelling. Assessment may include an examination, an ECG and blood tests.

Ask whether your symptoms could relate to anaemia, thyroid activity, blood sugar, dehydration or an electrical rhythm problem. Ask which medicines or supplements may contribute, whether you need an ECG or monitoring, and what symptoms should prompt urgent help.