Heart palpitations that come and go

Palpitations may appear after caffeine, nicotine, alcohol, poor sleep, stress, exertion, fever, or dehydration and fade when the trigger passes. Extra beats can also occur occasionally. Because an intermittent rhythm may be absent between episodes, a normal pulse in the clinic cannot always explain what you felt.

Anaemia, low blood sugar, thyroid overactivity, and atrial fibrillation are among the conditions a clinician may consider. Heart failure is more concerning when palpitations occur with breathlessness, swelling, or reduced ability to exercise. These symptoms need context rather than self-diagnosis.

Keep your phone or a written note ready to capture the start and end of each episode, what the heartbeat felt like, your pulse if safely measured, your activity, drinks, medicines, and symptoms. Rest during an episode and avoid driving if dizzy. Arrange an appointment when episodes repeat, last longer, or disrupt normal activities; a longer monitor may record an event that a brief ECG misses.

Get emergency help if an episode causes chest pain, fainting, severe breathlessness, confusion, or sudden weakness. Seek prompt advice for palpitations that continue, become markedly irregular, start during exertion, or occur with worsening swelling or breathlessness.

Would a wearable rhythm monitor help capture an episode? Which symptoms mean I should seek emergency care? Should my blood count, thyroid, glucose, or medication list be reviewed?