Irregular heart palpitations: what to know

Palpitations are an awareness of the heartbeat. Triggers can include stress, poor sleep, caffeine, dehydration, fever, or low blood sugar. Medical causes include anaemia, iron-deficiency anaemia, an overactive thyroid, and rhythm conditions such as atrial fibrillation. Anxiety can produce genuine pounding or fluttering without proving that anxiety is the cause.

A clinician may check your pulse, blood pressure, medicines, and blood tests, then arrange an electrocardiogram or longer heart monitoring. Heart failure and other conditions may need consideration when palpitations occur with breathlessness, swelling, or reduced exercise tolerance.

Sit down if you feel light-headed, breathe slowly, and avoid driving while symptoms are active. Keep hydrated unless your clinician has given you fluid restrictions. Record caffeine, alcohol, illness, meals, medicines, and emotional stress around each episode. Do not take someone else's rhythm medicine or alter a prescribed medicine without advice.

Arrange a routine appointment if episodes recur, become more frequent, or disturb sleep. Bring your episode notes and a complete list of medicines and supplements so the assessment can focus on patterns rather than a single moment.

Seek emergency help for palpitations with chest pain, severe breathlessness, fainting, new weakness on one side, confusion, or a severe persistent episode. These symptoms can signal a serious heart or circulation problem. If you have a known heart condition or are pregnant, seek advice sooner when the pattern changes.

Ask whether you need an ECG, blood tests, or ambulatory monitoring; which triggers to avoid; and whether your medicines could affect your pulse. Ask what duration or associated symptom should prompt urgent care for you specifically.