Heart palpitations for months: what to know

Repeated episodes can be linked with caffeine, stress, poor sleep, dehydration, medicines, or hormonal and thyroid changes. Anaemia can make the heart work harder, while atrial fibrillation may feel irregular. Generalised anxiety disorder can heighten awareness of bodily sensations, but anxiety should not be assumed before physical causes are considered. Heart failure may be relevant when there is progressive breathlessness, ankle swelling, or reduced ability to exercise.

Keep a diary for a few weeks: write down the date, activity, position, duration, rhythm quality, possible trigger, and associated symptoms. List prescribed medicines, non-prescription products, and stimulants. Make an appointment with a primary-care clinician, who may examine you, arrange blood tests, perform an electrocardiogram, or suggest a portable monitor. Do not stop prescribed treatment without advice. Gentle usual activity may be reasonable when you feel well, but stop if symptoms begin.

Emergency help is needed for chest pressure or pain, fainting, severe breathlessness, confusion, or severe dizziness with palpitations. A new persistent irregular rhythm with marked weakness also needs urgent assessment. A months-long history does not make a sudden change safe to ignore.

Could a monitor capture an episode? Which blood tests are relevant? How should I manage exercise, caffeine, and symptoms while the cause is being investigated?