When to worry about palpitations with heart failure

Palpitations is a common presentation of Heart Failure. A heartbeat may feel fast, forceful or irregular when the heart is under strain or when a rhythm disturbance develops. Breathlessness, tiredness, ankle swelling and needing extra pillows can indicate that fluid or heart-failure symptoms are changing.

A sensation alone cannot show whether heart failure has worsened. Compare it with your usual symptoms and follow the monitoring plan given by your heart-failure team.

Stop and rest if palpitations begin during activity. Record the time, pulse pattern, breathing symptoms, swelling and any recent illness or missed dose. Take prescribed heart-failure medicines as directed; do not double a dose or increase diuretics unless your clinician has given a specific plan. Follow your agreed fluid and salt guidance.

Call emergency services for severe or sudden breathlessness, chest pain, collapse, fainting, blue or grey lips, or new confusion. Seek prompt advice for palpitations that persist, a rapid change in weight or swelling, worsening breathlessness at rest, or a clear drop in your ability to do normal activities.

Ask which pulse or symptom changes should prompt a call, how to use your weight and swelling record, and whether an electrocardiogram or medicine review is needed. Confirm what to do if you miss a dose or cannot keep medicines down.