What should you know about regular heart palpitations?

Palpitations may happen when the heartbeat becomes more noticeable, even when its rhythm is normal. Common triggers include stress, poor sleep, strenuous activity, caffeine, nicotine, alcohol, fever, and some medicines. Dehydration or low blood glucose can also make the heart feel as though it is beating harder or faster.

Some medical conditions present with palpitations. Anaemia and iron deficiency anaemia can reduce oxygen delivery and prompt the heart to work harder. Hyperthyroidism can increase the body’s drive and heart rate. Generalised anxiety disorder can cause repeated episodes alongside worry and physical tension. Atrial fibrillation is an irregular rhythm that may cause palpitations, while heart failure can cause them with breathlessness, tiredness, or swelling. These associations do not identify the cause in an individual person.

Keep a brief record of when the sensation starts, how long it lasts, whether the rhythm feels regular or uneven, what you were doing, and any dizziness, chest discomfort, or breathlessness. Note caffeine, alcohol, nicotine, new medicines, illness, and fluid intake around episodes. This information can help a clinician decide whether you need an examination, blood tests, or heart-rhythm monitoring.

Until you have advice, avoid stimulants that clearly trigger episodes, drink fluids normally, and do not stop prescribed medicine without discussing it with the prescriber. Arrange a routine appointment when episodes are new, frequent, disruptive, or different from your usual pattern.

Get emergency help if palpitations are accompanied by chest pain or pressure, severe breathlessness, fainting, new confusion, or marked weakness. Seek urgent assessment for a sustained very fast or clearly irregular heartbeat, especially if you feel unwell. Sit down, avoid driving yourself, and take your medication list with you if symptoms are severe. A pattern that stops on its own can still deserve assessment when it keeps returning.

Ask whether your symptoms suggest an irregular rhythm and whether an ECG or longer rhythm monitor would help capture an episode. Discuss blood tests for anaemia, iron deficiency, thyroid problems, or glucose changes when appropriate. Tell the clinician about medicines, supplements, energy drinks, sleep disruption, and family history of heart rhythm problems. Ask which symptoms should prompt emergency care and how to record an episode safely.