Fatigue and heart palpitations: what to know

Palpitations may feel like fluttering, pounding, skipped beats or a heartbeat that suddenly becomes noticeable. Lack of fluid, fever, stimulants, emotional strain and poor sleep can make the heart beat faster. Anaemia and iron deficiency anaemia can reduce oxygen delivery, while hyperthyroidism can increase the body's pace and trigger sweating or tremor. Atrial fibrillation can cause an irregular rhythm; heart failure may occur with breathlessness, ankle swelling or reduced exercise tolerance. These symptoms do not identify one diagnosis on their own.

Record when episodes begin, how long they last, whether the rhythm feels regular, and what you were doing beforehand. Note caffeine, nicotine, alcohol, medicines, illness, meals and fluid intake. Rest in a cool place, drink fluids if you can, and avoid strenuous activity while symptoms are active. A clinician may review your pulse, blood pressure, medication list and an electrocardiogram, with blood tests guided by your history.

Seek emergency care for palpitations with chest pain, severe breathlessness, fainting, new confusion, or marked weakness. Arrange prompt medical assessment if episodes keep returning, last longer than usual, occur during exertion, or come with swelling or breathlessness. Do not drive yourself if you feel faint.

Could my medicines, stimulant use, fluid intake or blood sugar be contributing? Should I have an electrocardiogram or blood tests for anaemia and thyroid function? What symptoms should change the urgency of my follow-up?