What should you know about slow heart palpitations?

Palpitations are an awareness of the heartbeat: pounding, fluttering, skipping, or beating unusually slowly. The sensation does not always match the pulse rate. Dehydration, low blood sugar, fever, stress, poor sleep, caffeine, nicotine, and some medicines can alter how the heartbeat feels. Anaemia and iron deficiency anaemia may make the heart work harder. Atrial fibrillation can produce an irregular rhythm, while hyperthyroidism can stimulate a fast or forceful heartbeat. Heart failure may cause palpitations with breathlessness, swelling, or reduced exercise tolerance.

Sit down, breathe steadily, and check your pulse if you can do so safely. Note whether it feels regular or irregular, how long the episode lasts, what you were doing, and any caffeine, alcohol, illness, or medicine changes. Avoid driving during a troubling episode. Arrange a clinical review if episodes are new, recurrent, prolonged, or associated with dizziness; an examination and an electrocardiogram may help identify the rhythm.

Call emergency services for palpitations with chest pain, fainting, severe breathlessness, confusion, new weakness, or a sustained very irregular heartbeat. Seek prompt medical advice for repeated episodes, a known heart condition, or symptoms that occur with swelling or marked fatigue. Do not assume a slower sensation is harmless when you feel unwell.

Ask whether you need an electrocardiogram, blood tests for anaemia, thyroid function or glucose, and a monitor to record episodes that do not occur during the visit.