Palpitations are the awareness of your heartbeat: fast, forceful, or irregular. Most are benign (caffeine, poor sleep, stress, fever) — a few are the symptom of a rhythm disorder needing diagnosis. The distinction lives in the company they keep.
In short — what to do
- Sit, calm down, breathe slowly.
- If your doctor taught you a vagal manoeuvre (like forceful coughing or bearing down), use it — never improvise ones you weren't taught.
- Feel your pulse or record it (smartwatch/phone) — capturing the episode is a diagnostic treasure for your doctor.
- It stopped on its own and you feel fine? Book an appointment and bring your recording.
Videos for this topic
Heart racing? It is not always the coffee
21 secondsIf palpitations come with dizziness, breathlessness or chest pain: sit or lie down and get medical help now. Record your pulse during the episode if you can, for example on a smartwatch.
Watch it on InstagramCapsule: the first seconds of a palpitations episode
10 secondsMove the coffee and energy drinks away, sit them on the floor instead of letting them stand up suddenly, and record the pulse before the medical assessment.
Your heart skipping or racing chaotically? The biggest mistake in that moment
23 secondsDon't self-diagnose online or settle for a cup of herbal tea. Rest and sit somewhere safe, don't drive, and get an ECG, the only test that names the rhythm problem. If dizziness, breathlessness, chest pain or fainting come with the palpitations: go to the ER at once.
Usually benign
- After caffeine, energy drinks, or smoking.
- With stress, sleep deprivation, or fever.
- Occasional "skipped" beats then normal rhythm — common in the healthy.
Worth assessment
- Episodes that start and stop abruptly like a switch, or extreme speed at rest.
- Totally irregular "quivering" palpitations — especially over sixty: may be atrial fibrillation, which raises stroke risk.
- Palpitations on exertion, or in anyone with known heart disease or a family history of early sudden death.
During an episode
- Sit, calm down, breathe slowly.
- If your doctor taught you a vagal manoeuvre (like forceful coughing or bearing down), use it — never improvise ones you weren't taught.
- Feel your pulse or record it (smartwatch/phone) — capturing the episode is a diagnostic treasure for your doctor.
- It stopped on its own and you feel fine? Book an appointment and bring your recording.
998 or the ER immediately if palpitations come with
- Chest pain or breathlessness.
- Fainting or near-fainting.
- Severe dizziness or cold sweat.
- Extreme speed continuing beyond 20–30 minutes without stopping.
One moment
The best gift you can give your doctor: a recording of the episode as it happens — a felt pulse, a smartwatch trace, a wrist ECG. Palpitation diagnosis lives on "catching it in the act".
This content is for general health education only and is not medical advice. Always seek guidance from a qualified healthcare professional. In an emergency, call 998.