What should you know about intermittent palpitations?

Palpitations are an awareness of your heartbeat: it may feel fast, forceful, fluttering, irregular, or as if a beat has been missed. Brief episodes can occur with anxiety, poor sleep, caffeine, nicotine, alcohol, fever, or strenuous activity. Dehydration and low blood sugar can also make the heartbeat feel more noticeable. Anaemia, iron deficiency anaemia, or an overactive thyroid can contribute to recurring symptoms.

Atrial fibrillation is one possible rhythm problem, but a sensation of fluttering does not prove that diagnosis. The timing, pulse pattern, duration, associated symptoms, medicines, and personal heart history help a clinician judge what is happening. Keep the description factual rather than trying to label the rhythm yourself.

Stop and sit somewhere safe while an episode is happening. Note when it began, what you were doing, whether the rhythm felt regular or uneven, how long it lasted, and whether you had chest discomfort, breathlessness, dizziness, or faintness. If you have been told how to check your pulse, record what you find without delaying urgent care.

Drink fluids if you may be dehydrated, eat regular meals, and reduce caffeine, nicotine, alcohol, and non-prescribed stimulants if they appear to trigger symptoms. Do not stop prescribed medicine without advice. Arrange a routine review when palpitations recur, become more frequent, last longer, begin after a medicine change, or occur with tiredness, weight change, thirst, or breathlessness. An examination, blood tests, or heart-rhythm recording may be considered.

Call emergency services for palpitations with chest pain or pressure, severe breathlessness, fainting, collapse, new confusion, or marked weakness. Seek urgent assessment if the heartbeat remains very fast or irregular and does not settle, especially if you feel unwell.

Do not drive yourself while faint, severely dizzy, or short of breath. A history of heart disease, a family history of sudden cardiac death, or palpitations during exertion lowers the threshold for prompt medical advice. Heart failure can cause breathlessness, swelling, and fatigue alongside awareness of the heartbeat; these symptoms warrant medical review rather than home monitoring alone.

Ask: Could a medicine, thyroid problem, anaemia, dehydration, or low blood sugar be contributing? Should I have an electrocardiogram or a longer rhythm monitor? What symptoms mean I should call emergency services? Is exercise safe while the episodes are being assessed?