What should you know about weird heart palpitations?

Palpitations may feel like fluttering, pounding, racing, skipping or an extra beat. They can occur with stress, poor sleep, caffeine, nicotine, fever, dehydration or low blood glucose. Anaemia, Iron Deficiency Anaemia and Hyperthyroidism can also present with awareness of a fast heartbeat. An intermittent rhythm condition such as Atrial Fibrillation may cause an irregular pulse, while Heart Failure is more concerning when palpitations occur with breathlessness, swelling or reduced exercise tolerance.

Sit down if you feel light-headed and avoid driving until the episode passes. Record the start and end time, pulse if you can measure it safely, regular or irregular pattern, activity, drinks, medicines and symptoms. Reduce stimulants and maintain fluids unless a clinician has restricted them. Arrange a medical review for repeated episodes, a new persistent rhythm, or palpitations that interfere with sleep or activity; an examination and heart tracing may be useful.

Call emergency services for palpitations with chest pain, severe breathlessness, fainting, new confusion, blue lips or a sustained very fast or irregular heartbeat. Seek prompt care for an episode with marked dizziness, weakness, new swelling or worsening breathlessness. Do not dismiss symptoms because anxiety is present; Generalised Anxiety Disorder can cause palpitations, but other causes may need checking.

Ask whether you need an ECG, blood tests for anaemia, thyroid problems or glucose, and monitoring for intermittent rhythms. Share every medicine, supplement and stimulant, and mention dehydration, bleeding symptoms, weight change or a family history of heart disease.