I have heart palpitations every day: what should I know?

Palpitations are sensations such as a racing, pounding, fluttering or skipped heartbeat. They may happen at rest or during activity. Keeping a record of when they occur and what you feel alongside them can help the clinician decide which checks are useful.

Common triggers include caffeine, nicotine, alcohol, some medicines, poor sleep, emotional stress and strenuous exercise. Dehydration or low blood sugar can also make the heartbeat feel more noticeable. Anaemia, including iron deficiency anaemia, and an overactive thyroid can cause a faster heartbeat. An irregular rhythm such as atrial fibrillation is another possibility; palpitations themselves do not identify the cause.

A clinician may ask about your medical history and medicines, check your pulse and blood pressure, and arrange an electrocardiogram or blood tests. Sometimes a longer period of heart monitoring is needed when episodes come and go.

Arrange a routine medical appointment if palpitations are happening every day, are becoming more frequent, or have no clear trigger. Until you are assessed, note the time, duration, activity, drinks or medicines beforehand, and symptoms such as breathlessness or light-headedness. Do not stop prescribed medicine without advice. You can reduce avoidable triggers by limiting caffeine and nicotine, avoiding recreational stimulants, drinking fluids regularly, and keeping meals and sleep as consistent as possible.

Call emergency services now if palpitations are accompanied by chest pain or pressure, severe breathlessness, fainting, marked dizziness, confusion, or unusual sweating, or if the heartbeat remains very fast and you feel seriously unwell. Seek prompt medical advice for a new irregular heartbeat, episodes during exercise, or palpitations with leg swelling or breathlessness when lying down. These symptoms need assessment regardless of whether anxiety, dehydration or another trigger seems possible.

Ask what might be triggering the episodes, whether you need an electrocardiogram or blood tests, and whether your medicines or supplements could contribute. Tell the clinician about fainting, chest discomfort, breathlessness, thyroid symptoms, heavy bleeding, diabetes, heart disease or a family history of rhythm problems. Bring your symptom record and a list of everything you take, including energy products and non-prescription medicines.