Heart palpitations with a normal heart rate

A forceful beat after a brief pause, an occasional extra beat, or a change in rhythm may feel like a thump or flutter while the pulse count remains within its usual range. Caffeine, nicotine, poor sleep, stress, dehydration, fever, and some medicines can make normal beats more noticeable.

A single pulse check may miss an intermittent rhythm. Palpitations can also accompany anaemia, thyroid overactivity, low blood sugar, or atrial fibrillation. The sensation does not by itself show which explanation applies.

Write down when the sensation starts, how it feels, how long it lasts, your pulse if you can check it safely, and any trigger such as exercise or caffeine. Review medicines and supplements with a clinician rather than stopping a prescribed treatment yourself. A clinician may use an ECG, blood tests, or a wearable monitor if the episodes are recurring.

Get emergency help if palpitations come with chest pain, fainting, severe breathlessness, new weakness, or confusion. Arrange prompt medical advice when episodes are new, becoming more frequent, occur with exertion, or cause dizziness, even if the pulse seems normal at the time.

Could an extra beat or intermittent rhythm explain this feeling? Do I need an ECG or an ambulatory monitor? Should my blood count, thyroid, electrolytes, or glucose be checked?