What should you know about high palpitations?

Palpitations can happen after exertion, poor sleep, stress, caffeine, nicotine, alcohol, dehydration, fever, or some medicines. They can also occur with anaemia, low blood sugar, an overactive thyroid, anxiety, or an abnormal rhythm such as atrial fibrillation. Feeling your heart beat strongly does not by itself show which cause is present.

Record whether the rhythm feels regular or uneven, how long an episode lasts, what you were doing, and whether dizziness, breathlessness, chest discomfort, or faintness occurred. This information can help a clinician decide whether an electrocardiogram or blood tests are needed.

Pause strenuous activity, sit somewhere safe, and breathe slowly. Drink water if you may be dehydrated and avoid additional caffeine, nicotine, and alcohol until the episode settles. Arrange an appointment if episodes recur, last longer than usual, occur at rest, or interfere with sleep or daily life. Do not take someone else’s heart medicine.

Seek advice about medicines, supplements, weight-loss products, and decongestants that may affect heart rate. A clinician may check your pulse, blood pressure, heart rhythm, thyroid function, blood count, and glucose depending on your symptoms.

Call emergency services for palpitations with chest pain, severe breathlessness, fainting, collapse, marked dizziness, new weakness, or confusion. Get urgent help if a very fast or irregular heartbeat continues while you are resting, especially if you have known heart disease.

Could my symptoms relate to anaemia, thyroid activity, dehydration, low blood sugar, anxiety, or an abnormal rhythm? Should I have an electrocardiogram or a wearable rhythm monitor? Which medicines and stimulants should I avoid, and what episode should trigger emergency help?