When to worry about palpitations with generalised anxiety disorder

Palpitations is a very common presentation of Generalised Anxiety Disorder. Worry can activate the body's stress response, increasing heart rate and making each beat more noticeable. Fast breathing, trembling, sweating, tight muscles and a sense of alarm may accompany an episode.

Anxiety can coexist with heart rhythm problems, medication effects, thyroid disorders or dehydration. A familiar trigger does not rule out another cause, particularly when the sensation is new, unusually strong, irregular or unrelated to worry.

Sit down, loosen tight clothing and breathe slowly, allowing the out-breath to last longer than the in-breath. Reduce caffeine and nicotine, and make a note of the setting, duration and associated symptoms. Use your agreed anxiety plan, but do not use someone else's sedative or heart medicine to stop the sensation.

Call emergency services for chest pain, fainting, severe difficulty breathing, new weakness, confusion, or trouble speaking or seeing. Arrange prompt clinical review if palpitations last unusually long, recur without anxiety, disturb sleep repeatedly, or come with marked dizziness. If you feel unsafe, ask someone to stay with you while help is arranged.

Ask how to distinguish your usual anxiety symptoms from warning signs, whether your medicines or stimulants could contribute, and whether an electrocardiogram or monitoring would be useful. Request a written plan for future episodes.