What should you know about chest palpitations?

You may notice palpitations in your chest, throat, or neck, either at rest or during activity. Emotional stress, poor sleep, fever, strenuous exercise, caffeine, nicotine, alcohol, and some medicines can make the heartbeat feel more noticeable. Palpitations can also occur with dehydration, hypoglycaemia, anaemia, iron deficiency anaemia, or hyperthyroidism. Atrial fibrillation and other rhythm changes are less common possibilities. The sensation itself does not identify the cause, so a clinician may consider your symptoms, pulse, medical history, and medicines together.

Stop strenuous activity and sit somewhere safe while you observe the episode. Note when it began, how long it lasted, whether the rhythm felt regular or uneven, and what you were doing beforehand. Avoid extra caffeine, nicotine, alcohol, and non-prescribed stimulant products until you have advice. Drink fluids if you may be dehydrated, unless a clinician has told you to restrict fluids. Arrange a medical review if episodes recur, last longer than usual, begin during exercise, or come with dizziness. Do not stop prescribed medicine without discussing it with the prescriber.

Seek emergency help if palpitations are accompanied by chest pain or pressure, severe breathlessness, fainting, new confusion, or marked weakness. Urgent assessment is also appropriate when a very fast or irregular heartbeat does not settle, particularly if you have known heart disease or symptoms suggesting heart failure. If the episode has stopped but included fainting, significant dizziness, or breathlessness, contact a healthcare professional promptly.

Ask what checks may help identify the cause, whether an ECG or blood tests are suitable, and whether any medicine or supplement could be contributing. Share your episode diary, family history of rhythm problems, and any associated faintness, breathlessness, chest discomfort, or exercise-related symptoms.