I'm panicking a lot, my heart is pounding; I feel like it will stop, I'm afraid of dying and of having a heart rhythm disorder

Go to the emergency department or call emergency services right away if you have any of the following:

• Severe chest pain or a pressure/crushing sensation
• Marked difficulty breathing or inability to speak because of breathlessness
• Fainting, loss of consciousness or severe light‑headedness
• Sudden severe dizziness or neurological signs (vision changes, difficulty speaking)
• Signs of a severe allergic reaction or uncontrolled bleeding

For initial evaluation the following options may be appropriate:

• Family Medicine or Internal Medicine: general assessment, review of risk factors and referral for further testing if needed
• Cardiology: for evaluation of heart rhythm and structure when palpitations are recurrent or ECG abnormalities are suspected
• Mental Health and Illnesses specialist (psychiatry/psychology): if panic or anxiety symptoms are the main problem and psychological support is needed
• Emergency Medicine: if symptoms suddenly worsen or any of the emergency signs above are present
• Neurology: if you have accompanying neurological findings

Clinicians will take a detailed history and perform a physical exam. They may order tests such as:

• Electrocardiogram (ECG) to record heart rhythm
• Blood tests and other investigations if indicated to assess overall health
• Discussion of triggers and lifestyle factors (caffeine, sleep, stress)

These are general, low‑risk supportive steps and do not replace medical care:

• Sit or lie down in a comfortable position and try to remain calm
• Focus on slow, deep breathing
• Drink fluids and avoid dehydration
• Keep a note of when symptoms start, how long they last and any triggers
• Seek medical assessment if symptoms worsen or repeat

It is helpful to report the following at your appointment:

• When the palpitations began, how long an episode lasts and how often they occur
• Other accompanying symptoms (chest pain, breathlessness, fainting, etc.)
• Use of caffeine, nicotine, alcohol or stimulants
• Known chronic conditions and family history of heart disease
• All medicines and supplements you are taking (prescription or over‑the‑counter)