Keep getting palpitations: what should you know?

Palpitations are sensations such as pounding, racing, fluttering, or skipped beats. They can happen at rest or during activity. A clinician may ask about your pulse, medicines, caffeine, sleep, stress, hydration, and any chest or breathing symptoms.

Common triggers include caffeine, nicotine, alcohol, lack of sleep, emotional stress, fever, strenuous exercise, and some cold or asthma medicines. Dehydration or low blood sugar can also make the heartbeat feel more noticeable.

Sometimes palpitations occur with anaemia, iron deficiency anaemia, an overactive thyroid, or an abnormal heart rhythm such as atrial fibrillation. The sensation alone cannot identify the cause. Heart failure is another condition that may be associated with palpitations, particularly when there is breathlessness, swelling, or unusual tiredness.

Write down when each episode starts, how long it lasts, what you were doing, whether the rhythm feels regular or uneven, and any symptoms alongside it. If you can safely check your pulse, record what you notice without delaying care.

Arrange a primary-care appointment if palpitations keep returning, even if they stop on their own. Bring a list of prescribed medicines, supplements, and stimulants, and mention recent illness, heavy bleeding, thyroid problems, pregnancy, or changes in exercise.

Until you are assessed, avoid excess caffeine, nicotine, recreational drugs, and energy drinks. Drink fluids regularly unless a clinician has told you to restrict them, and keep a symptom diary. Do not stop prescribed treatment without medical advice.

Assessment may include a heart examination, an electrocardiogram, and blood tests. If an episode is intermittent, a clinician may suggest a wearable monitor to capture the rhythm while symptoms occur.

Seek emergency help now if palpitations are accompanied by chest pain or pressure, severe breathlessness, fainting, near-fainting, confusion, or marked weakness. Treat a sustained very fast or irregular heartbeat with dizziness as urgent as well.

Do not drive yourself if you feel faint or unwell. Sit or lie down while waiting for help, and tell the emergency team when the episode began, what symptoms occurred, and which medicines you take.

Ask: Could my symptoms be caused by a heart rhythm problem, anaemia, thyroid disease, dehydration, or low blood sugar? Do I need an electrocardiogram, blood tests, or rhythm monitoring? Which symptoms should make me seek emergency help? Should I change any medicines, supplements, caffeine, or exercise while this is being assessed?