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An awareness of your heartbeat — racing, pounding, fluttering, or skipping beats. Usually benign but can be frightening.
There are several possible causes. Here are the most common ones:
Adrenaline causes the heart to beat faster and harder.
You might suspect this if you have:
Coffee, energy drinks, and some medications.
You might suspect this if you have:
Normal response to activity.
You might suspect this if you have:
Low fluid volume increases heart rate.
You might suspect this if you have:
Abnormal heart rhythm requiring investigation.
You might suspect this if you have:
Hyperthyroidism increases heart rate.
You might suspect this if you have:
Important: This information is for general guidance only and should not be used to self-diagnose. A doctor can properly assess your symptoms and provide appropriate advice.
Call 000 or go to Emergency immediately
Heart palpitations are one of the most anxiety-provoking symptoms patients experience, but the vast majority are benign. When I assess palpitations, I first determine the pattern: are they regular or irregular? Brief or sustained? Associated with exertion or at rest? Palpitations during stress, after caffeine, or during exercise are almost always normal physiological responses. The features that raise concern are palpitations at rest that are irregular, sustained (more than 15 minutes), associated with dizziness or fainting, or occurring with chest pain. These may indicate an arrhythmia requiring investigation with an ECG or Holter monitor. Importantly, many patients with benign palpitations enter a cycle where anxiety about the palpitations causes more adrenaline, which causes more palpitations — breaking this cycle with reassurance and breathing techniques is often the most effective treatment.
Medical certificate guidance: Palpitations alone rarely prevent work unless they cause significant dizziness or anxiety. If palpitations required emergency assessment or investigation, time off for recovery and follow-up is appropriate.
All clinical decisions are made by AHPRA-registered doctors following our clinical governance framework. We never automate clinical decisions.
Most palpitations are harmless — caused by caffeine, stress, or exercise. However, palpitations with chest pain, fainting, or severe breathlessness need urgent assessment to rule out arrhythmias.
Not usually as a first step. Your GP can arrange an ECG and blood tests. Specialist referral is needed if an arrhythmia is detected or palpitations are frequent and unexplained.
Yes — anxiety is one of the most common causes. Adrenaline from the fight-or-flight response directly increases heart rate and force of contraction.
If your symptoms are keeping you from work or study, you can request a medical certificate through InstantMed. A doctor will review your symptoms and issue a certificate if clinically appropriate — typically for 1 to 3 days depending on severity. You don't need to be dramatically unwell; feeling genuinely too rough to function is reason enough.
Yes. Australian-registered doctors can assess your symptoms and issue valid medical certificates via telehealth. You fill in a detailed health questionnaire, a doctor reviews it, and if appropriate, your certificate is delivered digitally. No waiting room required.
You complete a structured health questionnaire covering your symptoms, duration, severity, and relevant medical history. The reviewing doctor uses this information — the same clinical reasoning they'd apply in a face-to-face consult — to determine whether a certificate, advice, or referral is appropriate.
A medical certificate covers the period stated on the document. If your symptoms worsen or don't improve as expected, you should see a GP in person or visit your nearest emergency department if it's urgent. Your certificate doesn't replace ongoing care — it's a point-in-time clinical assessment.
In some cases, yes. If a doctor reviewing your request determines that a common, non-restricted treatment is appropriate, they may issue a prescription as part of a consultation. Not all symptoms require or qualify for a prescription — the doctor will advise you on next steps.
Medical certificates are typically issued in under 30 minutes, available 24/7. Other requests are reviewed within 1–2 hours during operating hours (8am–10pm AEST, 7 days). You'll receive an email notification once your request has been reviewed.
If your symptoms suggest something that requires a physical examination, diagnostic tests, or specialist referral, the doctor will let you know and recommend appropriate next steps. Your safety is the priority — telehealth is a great option for many things, but it's not a replacement for hands-on assessment when that's what's needed.
No Medicare card is required for medical certificates. If you're requesting a prescription or consultation, a valid Medicare card is needed. Our service is private and does not attract a Medicare rebate, though any prescriptions issued can still attract PBS subsidies at the pharmacy.
Chest pain can indicate a heart attack or other serious conditions. Many cases are not life-threatening. Knowing the warning signs helps you decide when to seek emergency care.
A feeling of lightheadedness, unsteadiness, or spinning. Can range from mild to disabling.
Difficulty breathing or feeling like you can't get enough air. Can indicate serious conditions.
Our Australian-registered doctors can assess your symptoms and provide advice, treatment, or medical certificates if needed.
Get assessedThis information is for general educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making decisions about your health. Content on this page has been reviewed by AHPRA-registered Australian doctors but does not replace a personalised medical consultation.