What should you know about rapid heart palpitations?

Palpitations may occur when the heart beats faster, more forcefully, or irregularly. Stress, poor sleep, fever, caffeine, nicotine, alcohol, some medicines, dehydration, low blood sugar and anaemia can contribute. A rhythm condition such as Atrial Fibrillation can also present with palpitations; the sensation alone cannot identify its cause. Hyperthyroidism may add tremor, heat intolerance or weight loss, while Heart Failure may bring swelling or breathlessness.

Record when the episode began, how long it lasted, whether the rhythm felt regular, and what you were doing. Note associated dizziness, weakness or breathlessness and any new medicine or stimulant.

Stop strenuous activity and sit somewhere safe. Breathe slowly and avoid caffeine, nicotine and alcohol while symptoms continue. Sip fluids if you may be dehydrated and are able to drink. Do not take someone else’s heart medicine or change a prescribed dose. Arrange a medical review if episodes recur, last longer than usual, happen at rest, or come with an irregular pulse. A clinician may check your pulse, blood pressure, an electrocardiogram and blood tests.

Call emergency services now for palpitations with chest pain or pressure, fainting, severe breathlessness, confusion, or marked weakness. Seek same-day assessment when a fast heartbeat remains ongoing, feels very irregular, or occurs with significant dizziness. People with known heart disease, pregnancy, or a family history of sudden cardiac death should use a lower threshold for prompt advice.

Could this be an abnormal rhythm, anaemia, dehydration or a thyroid problem? Do I need an electrocardiogram, a wearable rhythm monitor, or blood tests? Which symptoms should prompt emergency care, and should I avoid any medicine, supplement or stimulant?