Oesophagus sensations and palpitations

A flutter, thump, racing feeling, or pause may be felt in the chest, throat, or upper abdomen. Oesophageal movement, trapped gas, reflux, muscle spasm, and anxiety can create nearby sensations that are not an abnormal rhythm. Triggers for true palpitations include dehydration, low blood sugar, anaemia, an overactive thyroid, stimulants, and some medicines. An irregular rhythm such as [Atrial Fibrillation](/conditions/atrial-fibrillation/) is one possible cause, but the feeling alone cannot identify it. A pulse check and electrocardiogram may help.

Note when episodes begin, how long they last, whether the pulse feels regular, and what you were doing beforehand. Record caffeine, nicotine, alcohol, illness, stress, meals, and medicines. Drink fluids unless a clinician has restricted them, eat regularly, and avoid stimulant products while waiting for review. Arrange an appointment for recurring episodes, a consistently fast pulse, or symptoms with exertion. People with known heart disease should seek tailored advice.

Call emergency services for palpitations with chest pressure, severe breathlessness, fainting, new confusion, or weakness on one side. Seek same-day assessment for a sustained rapid or very irregular heartbeat, repeated near-fainting, or symptoms after a new medicine. Do not drive yourself if you feel faint.

Ask whether you need an electrocardiogram, blood tests for anaemia or thyroid problems, medication review, or longer rhythm monitoring.