What should you know about intense heart palpitations?

Palpitations are an awareness of the heartbeat. They may feel fast, forceful, fluttering, or uneven. Stress, anxiety, lack of sleep, dehydration, fever, caffeine, nicotine, and some medicines can trigger them. Low blood sugar can also cause pounding or racing sensations.

Anaemia, iron deficiency anaemia, an overactive thyroid, or an abnormal rhythm such as atrial fibrillation can contribute. Heart failure may cause palpitations alongside breathlessness, swelling, or reduced exercise tolerance. The sensation itself does not identify its cause.

Stop exertion, sit or lie safely, and breathe slowly. Note when the episode began, whether the rhythm feels regular or irregular, how long it lasts, and what you were doing beforehand. Avoid stimulants until you have medical advice, and drink fluids if dehydration may be present.

Arrange a clinical review for new, repeated, or worsening episodes. A clinician may check your pulse, blood pressure, blood tests, and heart rhythm, sometimes while symptoms are happening.

Call emergency services for palpitations with chest pain or pressure, fainting, severe breathing difficulty, blue or grey lips, confusion, or marked weakness. Seek urgent assessment for a sustained very fast or clearly irregular heartbeat, especially if you feel dizzy.

Do not drive while faint, confused, or severely breathless. Bring a list of medicines, supplements, and known heart or thyroid conditions to the assessment.

Ask whether you need an electrocardiogram or monitoring, blood tests for anaemia or thyroid problems, advice about caffeine and medicines, and a clear plan for the next episode.