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What to do if…
you notice a new irregular heartbeat or skipped beats and feel unsettled

Short answer

If your palpitations/irregular heartbeat come with chest pain, shortness of breath, fainting/near-fainting, dizziness/lightheadedness, or unusual sweating, call 911. If there are no emergency symptoms but this is new or keeps happening, contact a clinician today (primary care/cardiology/urgent care) for evaluation.

Do not do these things

  • Do not drive yourself to get care if you feel faint, very dizzy, or unsteady.
  • Do not do intense exercise to “see if it goes away” while your rhythm feels off.
  • Do not take extra doses of prescribed medicine or someone else’s medicine to slow your heart.
  • Do not stack stimulants (energy drinks, high caffeine, nicotine, recreational stimulants) or binge alcohol to cope with the feeling.
  • Try not to re-check your pulse repeatedly in a way that escalates panic — take a quick note once, then follow the triage steps.

What to do now

  1. Pause and steady for 1–2 minutes. Sit down, feet planted. Slow your breathing so you can assess safely.
  2. Call 911 now if your palpitations/irregular heartbeat come with any of these:
    • Chest pain
    • Shortness of breath
    • Fainting, near-fainting, or loss of alertness
    • Dizziness or lightheadedness
    • Unusual sweating along with feeling unwell
  3. If no emergency symptoms, choose a same-day path to be checked.
    • Call your primary care office for urgent guidance, or
    • Go to urgent care if you can be seen promptly, or
    • Go to the ER if episodes won’t stop, symptoms are escalating, or you can’t get timely evaluation.
  4. Make a quick “episode note” (30–60 seconds). Write down:
    • Start time, how long it lasted, and what it felt like (fluttering, skipping, pounding)
    • What you were doing right before it started
    • Possible triggers in the last 6–12 hours: caffeine/energy drinks, alcohol, nicotine, decongestants, new supplements, recreational stimulants, dehydration, poor sleep, recent illness/fever
    • Any personal/family history of heart rhythm problems
  5. If you want to check your pulse, keep it gentle and brief. Wrist pulse is usually easiest. If you use your neck, touch lightly and one side only (do not press hard). If you feel worse while checking, stop and focus on getting care (911/ER/clinic based on symptoms above).
  6. Reduce risk while you arrange care.
    • Don’t drive; ask someone to stay with you or be reachable.
    • Avoid caffeine, nicotine, alcohol, and stimulant decongestants for now.
    • Sip water if you might be dehydrated (unless you’ve been told to limit fluids).
  7. If you have a wearable rhythm recording, save it (optional). It may help your clinician, but don’t delay care to capture a recording.

What can wait

  • You do not need to decide the cause right now (stress, caffeine, arrhythmia, etc.).
  • You do not need to start or stop medications on your own.
  • You do not need to research diagnoses — your next step is simply getting the right level of medical evaluation.

Important reassurance

Palpitations can feel intense and scary even when the cause is not dangerous. The goal right now is to catch the situations that need emergency help, and otherwise get a timely evaluation so you don’t have to guess.

Scope note

This guide covers first steps only. Testing and next decisions (like an ECG, monitoring, or medication changes) should be done with a clinician.

Important note

This is general information, not a diagnosis. If you feel seriously unwell, symptoms worsen, or you’re unsure, call 911 or go to the ER.

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