What should you know about daily heart palpitations?

Palpitations may feel like racing, fluttering, pounding or skipped beats. Caffeine, nicotine, lack of sleep, emotional stress, fever and some medicines can bring them on. Dehydration or low blood glucose can also cause a fast or forceful heartbeat.

A clinician may consider anaemia or iron-deficiency anaemia when palpitations occur with tiredness, breathlessness or dizziness. Hyperthyroidism can cause heat intolerance, tremor, sweating and weight loss. Atrial fibrillation may produce an irregular rhythm. Heart failure is more often associated with breathlessness, reduced exercise tolerance, leg swelling or needing extra pillows, rather than palpitations alone.

Keep a brief record of the time, duration, activity, pulse regularity, medicines, caffeine, meals and associated symptoms. Drink fluids regularly unless you have been given a fluid restriction, eat regular meals, and reduce stimulants if they clearly trigger episodes. Do not stop prescribed medicines without advice.

Book a GP appointment for recurring daily symptoms. Assessment may include an examination, an electrocardiogram and blood tests; a portable monitor may be considered when episodes are intermittent.

Call emergency services for palpitations with chest pain, severe breathlessness, fainting, collapse, new confusion or marked weakness. Seek prompt care if the heartbeat remains very fast or irregular, or if episodes are becoming longer or more intense.

Ask: Does my rhythm sound regular or irregular? Should I have an electrocardiogram or monitor? Could thyroid function, anaemia, hydration, glucose or a medicine explain this? Which symptoms mean I should seek emergency help?