Heart palpitations symptoms: what to know

You may notice the heartbeat in your chest, neck or throat, or feel a pause followed by a stronger beat. Episodes can happen at rest, after exertion, during stress or after caffeine. Dizziness, breathlessness, chest discomfort, unusual tiredness or fainting are more concerning companions. Palpitations can occur with dehydration, anaemia, an overactive thyroid, anxiety or a rhythm problem such as atrial fibrillation. These symptoms overlap, so the description does not diagnose a condition by itself.

During an episode, stop strenuous activity and sit somewhere safe. Note the start and end time, whether the rhythm feels regular or irregular, your activity, food, caffeine, medicines and other symptoms. A smartwatch reading can be useful context, but it cannot replace an ECG. Book a clinician review for repeated episodes, a new pattern or symptoms that concern you. Bring a medicine and supplement list, including decongestants and stimulant products.

Call emergency services for palpitations with chest pain, severe breathing difficulty, fainting, collapse, blue lips, new confusion or severe dizziness. Do not drive yourself if you feel faint. Even without those signs, seek prompt medical advice when episodes persist, occur with exercise, or become more frequent.

Ask what rhythm might explain the sensation, whether you need an ECG or a wearable monitor, and which symptoms should prompt emergency care. Ask whether thyroid, blood-count or hydration checks are appropriate.