Stress and heart palpitations: what to know

During stress, the body releases hormones that increase alertness and can make normal beats more noticeable. You may feel pounding in the chest, fluttering in the throat, skipped beats, or a racing pulse. These sensations may settle when the trigger passes, but stress is not the only possible cause. Dehydration, low blood sugar, anaemia, thyroid overactivity, medicines, stimulants, or an abnormal rhythm can also cause palpitations. Palpitations are a common presentation of several conditions, but feeling them does not tell you which condition is present.

Sit down safely, loosen tight clothing, and breathe slowly without forcing deep breaths. Note when the sensation began, how long it lasted, whether the rhythm felt regular, and what you were doing beforehand. Avoid nicotine, energy drinks, and extra caffeine while symptoms are active. Drink water if you may be dehydrated, unless a clinician has told you to restrict fluids. Arrange a review for recurring episodes; an examination and heart tracing may help distinguish a stress response from a rhythm problem. Do not stop prescribed medicines without advice.

Call emergency services if palpitations occur with chest pain or pressure, severe breathlessness, fainting, collapse, marked dizziness, or new weakness. Seek prompt assessment if the heartbeat remains very fast or irregular, starts during exertion, or occurs with swelling or breathlessness when lying down. Arrange medical advice for a first episode, repeated episodes, a family history of heart rhythm problems, or symptoms that are becoming more frequent. Do not drive yourself if you feel faint or unsafe.

Ask whether you need an ECG, blood tests, or monitoring, and whether medicines, caffeine, sleep, or anxiety may be contributing. Discuss whether symptoms fit Anaemia, Atrial Fibrillation, Dehydration, Generalised Anxiety Disorder, Heart Failure, Hyperthyroidism, Hypoglycaemia, or Iron Deficiency Anaemia.