What to do if…
your heart suddenly starts racing or pounding while you are at rest
Short answer
Stop what you’re doing, sit or lie down, and check for red-flag symptoms. If you have chest pain, shortness of breath, dizziness/lightheadedness, or fainting/near-fainting, call 999.
Do not do these things
- Do not drive yourself to A&E or “push through it”.
- Do not take extra doses of heart/blood pressure medicines, aspirin, or someone else’s medication “just in case”.
- Do not try to “burn it off” with exercise.
- Do not add stimulants right now (energy drinks, lots of caffeine, nicotine, recreational drugs).
- Do not take new “cold/flu” medicines to self-treat (some can worsen palpitations), unless a pharmacist/clinician advises it for you.
- Do not ignore it if this is new, happens at rest, or keeps recurring.
What to do now
- Get stable first. Sit with back support or lie down. If you feel faint, lie flat and raise your legs slightly.
- Red-flag check — call 999 or go to A&E now if you have palpitations with any of these:
- Chest pain/pressure (including pain spreading to arm/jaw/back)
- Shortness of breath
- Feeling dizzy or lightheaded
- Fainting or feeling like you might faint
- If no red flags, capture what’s happening (this helps clinicians).
- Note the time it started and what you were doing.
- Feel your pulse at your wrist/neck: does it feel regular or irregular?
- If you can, count beats for 30 seconds and write the number down.
- If you have a smartwatch/fitness tracker, save the reading (and any ECG recording if you already know how to do it safely).
- Reduce strain for the next 10–15 minutes.
- Loosen tight clothing. Avoid standing up quickly.
- Breathe slowly and steadily.
- Sip water if you may be dehydrated (skip if it makes nausea worse).
- Stop caffeine/nicotine/alcohol for now.
- Only use a clinician-taught technique if you’ve been taught it before.
- If you’ve previously been taught a manoeuvre for episodes of fast, regular rhythm, use only what you were taught — and only if you feel otherwise well (no chest pain, no breathlessness, no dizziness/near-fainting).
- If you haven’t been taught one, don’t experiment. Move to step 6.
- Get the right level of help based on how it’s going.
- If it’s still happening (even without red flags), call NHS 111 (or use 111 online) for urgent advice.
- If it’s stopped but this was new, unusually strong, lasted more than a few minutes, or keeps coming back, ask your GP surgery for an urgent appointment or contact 111.
- Seek urgent advice sooner if you’re higher risk. For example: known heart disease/arrhythmia, pregnancy/postpartum, recent procedure, severe infection/fever, significant dehydration, or medication changes that affect heart rhythm.
What can wait
- You don’t need to work out the exact cause right now.
- You don’t need to decide today about long-term tests or treatment.
- You don’t need to keep re-checking your pulse repeatedly once you’ve noted the key details.
Important reassurance
A sudden pounding or racing heartbeat can feel frightening even when it settles. Taking calm, practical steps and using the red-flag check is a sensible way to stay safe and get appropriate help.
Scope note
This covers first steps for the first minutes/hours. If episodes recur, clinicians may recommend ECG monitoring and blood tests, and review medicines and triggers.
Important note
This is general information, not a diagnosis. If you think you’re having a medical emergency or you feel seriously unwell, call 999.
Additional Resources
- https://www.nhs.uk/symptoms/heart-palpitations/
- https://www.nhs.uk/conditions/arrhythmia/
- https://www.nhsinform.scot/illnesses-and-conditions/cardiovascular-disease/heart-disease/heart-palpitations/
- https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/when-do-you-still-need-to-get-medical-help
- https://www.uhsussex.nhs.uk/resources/palpitations-emergency-department-leaflet/
About this guide
PanicStation.org guides are written as plain-English first steps, then reviewed for clarity, jurisdiction, and source quality. If you notice an error, outdated information, unclear wording, or a broken link, please contact us.