What it is
Racing heart (tachycardia) describes an abnormally fast heart rate — typically defined as above 100 beats per minute at rest — or the subjective experience of a rapid, pounding heartbeat.
An abnormally fast or pounding heartbeat experienced at rest — which may be physiological (exercise, anxiety) or indicate a cardiac arrhythmia requiring assessment.

At a glance
What it is
Racing heart (tachycardia) describes an abnormally fast heart rate — typically defined as above 100 beats per minute at rest — or the subjective experience of a rapid, pounding heartbeat.
Commonly experienced as
Evidence context
Research-supportedSee the evidence snapshotSafety
See staying safeContext
Racing heart describes the subjective experience or objective measurement of a heart rate that is faster than expected for the current physiological state. It encompasses sinus tachycardia (normal rhythm but fast rate, driven by physiological stressors including fever, anaemia, dehydration, pain, anxiety, or thyrotoxicosis) and pathological tachyarrhythmias (atrial fibrillation, SVT, atrial flutter, ventricular tachycardia). Anxiety and panic disorder produce the most common non-cardiac racing heart presentations — the sympathetic surge of the fight-or-flight response accelerates the sinus rate, often accompanied by palpitations and the perceived threat of cardiac danger. Postural orthostatic tachycardia syndrome (POTS) produces marked heart rate rise on standing. The clinical priority is distinguishing benign from potentially life-threatening causes through history, examination, and ECG.
The Evidence
What the evidence says about causes, investigation, and care options for a racing heart — and when to seek urgent assessment.
Racing heart has well-understood causes — but needs proper assessment
A racing heart can range from a benign stress response to a serious arrhythmia. The evidence base for investigation and management is strong, but distinguishing cause requires clinical assessment — not self-management alone.
Racing heart with chest pain, fainting, or breathlessness may indicate a serious arrhythmia and requires emergency assessment. Sudden-onset rapid heart rate that does not resolve, or racing heart in a young person during exertion with dizziness, also warrants urgent evaluation. Racing heart with weight loss, tremor, and heat intolerance may suggest a thyroid condition.
ECG is the primary tool for distinguishing sinus tachycardia from arrhythmia. Anxiety and panic disorder are among the most common non-cardiac causes, with strong evidence supporting CBT and SSRI approaches. SVT, AF, and POTS each have defined management pathways. Evidence quality is high for cardiac causes; moderate for anxiety-related presentations.
A clinician will take a detailed history, examine for signs of thyroid, cardiac, or autonomic causes, and arrange an ECG. Further tests may include blood work for anaemia, thyroid function, and electrolytes. The cause — not the symptom alone — determines the appropriate care pathway.
Slow extended-exhale breathing and cold water face immersion are traditional vagal activation practices with some physiological basis. Hawthorn berry is used in European herbal medicine for cardiac tone. Ayurvedic and acupuncture approaches address anxiety-related palpitations. Evidence for these approaches is limited; they should complement, not replace, professional assessment.
Using herbal cardiac agents without an ECG or clinical assessment is not appropriate — the cause must be established first. Excessive caffeine and stimulants should be avoided in any unexplained racing heart. If you are uncertain about the cause of your symptoms, professional assessment is the appropriate first step.
A GP or primary care clinician is the appropriate first contact for most racing heart presentations. Cardiology referral is indicated if arrhythmia is suspected or confirmed. Endocrinology input may be needed if thyroid disease is identified. For anxiety-related presentations, a mental health professional or psychologist experienced in CBT is well placed to help.
Safety first
General, informational guidance — not diagnostic. A qualified practitioner can advise on your own situation.
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