What should you know about heavy palpitations?

Palpitations can follow exercise, stress, poor sleep, caffeine, nicotine, alcohol, fever or dehydration. Anaemia, Iron Deficiency Anaemia, Hyperthyroidism and Hypoglycaemia can also make the heart feel fast or forceful. Generalised Anxiety Disorder may heighten awareness of normal changes in heartbeat.

Sometimes the rhythm itself is irregular. Atrial Fibrillation can cause an uneven, fast heartbeat and may occur with breathlessness or tiredness. Heart Failure is another condition that can cause palpitations alongside reduced exercise tolerance, swelling or breathlessness. The sensation alone cannot identify its cause.

Stop exertion and sit somewhere safe. Breathe slowly, note when the episode started, whether the rhythm feels regular or uneven, and record possible triggers. Sip fluids if dehydration may be involved. Avoid extra caffeine, nicotine and alcohol until you have clearer advice.

Arrange a clinical review if episodes are new, recurrent, prolonged, worsening or associated with fatigue, breathlessness or dizziness. A clinician may check your pulse, blood pressure, an electrocardiogram and blood tests based on your symptoms.

Call emergency services for palpitations with chest pain, severe breathlessness, fainting, new confusion, or collapse. Seek prompt assessment for a sustained very fast or irregular heartbeat, repeated dizziness, or symptoms that begin during exertion.

Ask whether your pulse feels regular, whether an electrocardiogram or blood tests are needed, and whether any medicine, stimulant, thyroid problem or blood condition could be contributing.