I keep having heart palpitations: what should I know?

Palpitations are an awareness of pounding, racing, fluttering or skipped beats. Caffeine, nicotine, alcohol, poor sleep, emotional stress, fever and dehydration can bring them on. Anaemia, Iron Deficiency Anaemia, Hyperthyroidism, Hypoglycaemia and Atrial Fibrillation are among the conditions a clinician may consider; the feeling itself does not diagnose any one of them.

Record when an episode starts, how long it lasts, what you were doing, your pulse if you can measure it safely, and whether dizziness, chest discomfort or breathlessness occurred. Mention new medicines, supplements, illness and family history of heart problems.

Sit down, breathe slowly, and avoid driving if you feel faint. Pause caffeine, nicotine and stimulant products while you arrange advice, and drink fluids if dehydration may be contributing and you have not been told to restrict them. Do not take a heart medicine belonging to someone else.

Arrange a prompt appointment when episodes recur, last longer than usual, begin with exertion, or come with fatigue, reduced exercise tolerance or swelling. Seek emergency help for palpitations with chest pain, severe breathlessness, fainting, new confusion, or a sustained very fast or irregular heartbeat with marked weakness.

Ask whether you need an examination, blood tests or an ECG, and whether a monitor could capture an episode. Discuss thyroid, iron, hydration and glucose factors, and ask which changes in rhythm or accompanying symptoms require emergency action.