What should you know about heart feels like its racing?

A heart that feels like it is racing may be palpitations, often triggered by stress, activity, caffeine, medicines, or illness, but new or persistent episodes need medical assessment. You may notice pounding, fluttering, skipped beats, or a thumping sensation in your chest, neck, or throat. The sensation can happen even when your heart rhythm is normal, although an irregular rhythm can also cause it.

Short episodes may follow exercise, poor sleep, emotional strain, fever, dehydration, or stimulants such as coffee, energy drinks, nicotine, and some cold remedies. Low blood sugar, an overactive thyroid, or anaemia can also make the heart beat faster as the body tries to deliver enough oxygen and energy. Some people experience palpitations during anxiety or panic. Atrial fibrillation is one heart-rhythm condition that can cause an irregular, racing pulse; heart failure can cause breathlessness and a fast heartbeat, especially with exertion. These conditions are possible explanations, not conclusions from the sensation alone.

Stop strenuous activity and sit somewhere safe. Breathe slowly and evenly, loosen tight clothing, and sip water if you may be dehydrated. Avoid caffeine, nicotine, alcohol, and non-prescribed stimulants until you understand the trigger. If you can do so safely, note when the episode began, how long it lasted, whether the beat felt regular or uneven, and what you were doing beforehand. Arrange a clinical review if episodes recur, last longer than usual, occur at rest, or are accompanied by unusual tiredness. A clinician may check your pulse, blood pressure, medicines, blood tests, and heart rhythm.

Seek emergency help now if the racing heartbeat comes with chest pain or pressure, severe breathlessness, fainting, collapse, confusion, or marked weakness. Urgent assessment is also needed for a new fast or irregular heartbeat that does not settle with rest, particularly if you have known heart disease or are pregnant. Do not drive yourself if you feel faint or seriously unwell. If symptoms have stopped but keep returning, arrange prompt medical advice so the rhythm and possible causes can be assessed.

You could ask: Could a medicine, thyroid problem, anaemia, dehydration, or low blood sugar explain this? Should I have an ECG or another rhythm check? Which symptoms mean I should seek emergency help? Is it safe for me to exercise, drink coffee, or take my usual cold medicines while this is being assessed? Bring a list of medicines and supplements, plus your episode notes.