Having heart palpitations all day: what to know

Palpitations are the feeling of a racing, pounding, fluttering, or skipped heartbeat. Triggers can include stress, poor sleep, caffeine, nicotine, fever, dehydration, or some medicines. Medical causes may include anaemia, iron deficiency anaemia, an overactive thyroid, low blood sugar, or an abnormal rhythm such as atrial fibrillation. Palpitations can occur with heart failure, but the sensation alone does not identify the cause.

A clinician may ask when the sensation began, whether it is constant or intermittent, and whether your pulse feels regular. They may check your heart rhythm, blood pressure, hydration, blood count, thyroid function, and blood sugar. An electrocardiogram or longer rhythm monitor can help capture an intermittent rhythm.

Stop strenuous activity and sit somewhere cool and calm. Avoid caffeine, nicotine, alcohol, and decongestants until you have been assessed. Sip fluids if you may be dehydrated, unless a clinician has told you to restrict fluids. Record the start time, possible triggers, your pulse if you can measure it, and symptoms such as dizziness or breathlessness. Arrange prompt medical advice for a new all-day episode, even if it settles.

Seek emergency help now for palpitations with chest pain, severe breathlessness, fainting, marked dizziness, confusion, or a very fast or irregular heartbeat that does not settle. Do not drive yourself if you feel faint. A history of heart disease, a new rhythm diagnosis, or pregnancy should lower the threshold for prompt assessment.

Ask whether you need an electrocardiogram, blood tests, or a rhythm monitor; whether any medicine or supplement could be contributing; and which activities, drinks, or symptoms should prompt urgent review.