Feeling a palpitation: what it can mean

Palpitations can feel like pounding, fluttering, skipped beats, or a racing heart in the chest, throat, or neck. Dehydration, fever, caffeine, nicotine, alcohol, poor sleep, and emotional stress can make the heartbeat more noticeable. Generalised Anxiety Disorder may amplify awareness of normal changes. Anaemia or Iron Deficiency Anaemia can make the heart work harder to deliver oxygen. Hyperthyroidism and Hypoglycaemia can also bring a fast or forceful heartbeat. Atrial Fibrillation may cause an irregular rhythm. Heart Failure can be associated with palpitations alongside breathlessness, swelling, or reduced exercise tolerance. The sensation itself does not diagnose a heart rhythm problem.

Stop strenuous activity, sit down, and breathe slowly. If you may be dehydrated, take fluids unless a clinician has advised fluid restriction. Record when the episode begins, how long it lasts, whether the rhythm feels regular, and what you were doing. Note caffeine, medicines, illness, dizziness, chest discomfort, and breathlessness. Arrange a review if episodes recur, last longer, or interfere with daily life; an examination and heart tracing may help identify the rhythm.

Seek emergency help for palpitations with chest pain, severe breathlessness, fainting, collapse, or marked dizziness. Urgent assessment is also needed if a fast or irregular heartbeat does not settle with rest, or if you have known heart disease and new symptoms. Do not drive while feeling faint or seriously unwell.

Ask whether you need an ECG, blood tests for anaemia, thyroid function or glucose, and a medication or stimulant review.