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us Health & medical scares heart racing at rest • heart pounding suddenly • palpitations while resting • rapid heartbeat episode • fast pulse sitting down • fluttering in chest • irregular heartbeat feeling • sudden tachycardia at rest • pounding heartbeat lying down • skipped beats sensation • new heart palpitations • lightheaded with palpitations • dizzy during rapid heartbeat • shortness of breath and palpitations • chest pain with palpitations • anxiety-like heart symptoms • unexplained fast heartbeat • resting heart rate feels high • sudden pounding heart at night

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 emergency warning signs. If you have chest pain/pressure, trouble breathing, or fainting/near-fainting, call 911.

Do not do these things

  • Do not drive yourself to the ER if you feel faint, weak, confused, or unsafe to drive.
  • Do not take extra doses of heart/blood pressure meds, aspirin, or someone else’s medication unless a clinician told you to for this exact situation.
  • Do not try to “work it off” with exercise.
  • Do not add stimulants right now (energy drinks, lots of caffeine, nicotine, recreational drugs).
  • Do not take oral decongestants for a “stuffy nose” to self-treat (they can worsen palpitations) unless a clinician/pharmacist advises it for you.
  • Do not dismiss it if it’s new, happening at rest, or repeating.

What to do now

  1. Get stable first. Sit with back support or lie down. If you feel like you might pass out, lie flat and raise your legs slightly.
  2. Emergency warning signs — call 911 now if any apply right now:
    • Chest pain/pressure (including pain spreading to arm/jaw/back)
    • Shortness of breath, or you can’t speak full sentences
    • Fainting, near-fainting, or severe lightheadedness
    • You feel suddenly “very unwell” (for example, profound weakness or you can’t stay upright)
  3. Capture useful details while you’re still and safe (this helps the ER/urgent care/your clinician).
    • Note the start time, what you were doing, and anything you took in the last few hours (caffeine, alcohol, cannabis/stimulants, cold medicines, new prescriptions).
    • Check your pulse: does it feel regular or irregular? If you can, count beats for 30 seconds and write the number.
    • If you have a smartwatch/fitness tracker, save the reading (and any ECG recording if you already know how to do it safely).
  4. 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 worsens nausea).
  5. Only use a clinician-taught technique if you’ve been taught it before.
    • If a clinician previously taught you 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.
  6. Choose the right care level if it’s not an emergency but isn’t resolving.
    • If it’s ongoing and you feel worse, unsafe, or unsure: go to an Emergency Department (or call 911 if warning signs develop).
    • If it’s ongoing but you feel stable: seek same-day medical advice (urgent care, telehealth, your doctor’s on-call line, or your health plan’s nurse line).
    • If it stopped, but this was new, unusually strong, lasted more than a few minutes, or keeps coming back: arrange prompt evaluation (ideally same day/next day depending on access).
  7. Seek care sooner if you’re higher risk. For example: known heart disease/arrhythmia, pregnancy/postpartum, recent surgery/procedure, severe infection/fever, significant dehydration, stimulant medication changes, or a history of fainting with palpitations.

What can wait

  • You don’t need to identify the exact cause right now.
  • You don’t need to decide today about long-term testing or medications.
  • You don’t need to keep re-checking your pulse repeatedly once you’ve recorded the key details.

Important reassurance

This can feel intense and scary, even when it turns out not to be dangerous. A calm “safety first” approach—warning signs, rest, and timely evaluation—helps you get the right care and reduces risk.

Scope note

These are first steps for the moment. If episodes recur, clinicians may recommend an ECG, portable monitoring, lab tests (such as thyroid or anemia checks), and a medication review.

Important note

This is general information, not a diagnosis. If you think you’re having a medical emergency or you feel seriously unwell, call 911.

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