Strongly felt beats can reflect brief rhythm changes or temporary triggers. Note how long episodes last, how often they occur and any accompanying symptoms (fatigue, dizziness, shortness of breath). If symptoms persist, see a health professional.
The absence of dizziness or shortness of breath lowers the likelihood of some emergencies, but frequent or very intense palpitations still warrant evaluation. If you experience chest pain, fainting, sudden worsening, or if these episodes interfere with daily life, seek immediate help. Otherwise a primary care (Family Medicine or Internal Medicine) evaluation is a reasonable first step.
Go to the emergency department right away if you have any of the following: severe chest pain, sudden or severe shortness of breath, fainting or near-fainting, decreased consciousness. These are medical red flags requiring immediate evaluation.
The first step is usually a Family Medicine or Internal Medicine clinician. Based on their assessment you may be referred to Cardiology for rhythm or heart-related causes. If anxiety seems to contribute, Mental Health services (psychiatry/psychology) can help. Emergency Medicine is appropriate if red-flag symptoms are present.
A clinician will take a history and perform a physical exam. Tests may be ordered when indicated, such as an electrocardiogram (ECG), ambulatory rhythm monitoring (for example Holter), blood tests and other targeted evaluations. The need for tests is determined by your doctor based on individual findings.
The following general measures may reduce some palpitations; they do not replace medical care and you should see a clinician if symptoms continue or worsen.
If these measures do not help or symptoms worsen, consult a health professional.
Palpitations accompanied by severe chest pain, fainting, sudden significant shortness of breath or reduced consciousness require emergency evaluation. Recurrent, frequent or quality-of-life–impacting palpitations also merit medical assessment.
Common triggers include high caffeine intake, acute stress, lack of sleep, alcohol and some medical conditions. Individual triggers vary, so noting what precedes an episode can be helpful.
Begin with a Family Medicine or Internal Medicine physician. They can perform initial assessment and refer you to Cardiology or other specialists as needed.
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