POTS Heart Palpitations: What to Log

Updated 29 Oct 2026

The NHS describes PoTS as when your heart rate increases after getting up from sitting or lying down (NHS PoTS guidance). Palpitations are one of the ways that can feel, and they are easier to describe at a visit when you have dates, positions, and durations.

This guide covers what to log about heart palpitations with POTS: how they feel, timing and position, possible triggers, medicines, tests, and the signs that need urgent help.

Why palpitations are worth logging with POTS

POTS Journey (part of Health Journey Labs) reviewed the NHS guidance. The NHS lists noticeable heartbeats (heart palpitations) among the symptoms that happen when you stand up and can get better when you sit or lie down, alongside dizziness or light-headedness, chest pain, shortness of breath, shaking and sweating, and fainting or nearly fainting (NHS PoTS guidance). It adds that PoTS affects everyone differently, that symptoms may be worse in the morning, and that they may change from day to day (NHS PoTS guidance).

The NHS also notes that symptoms of PoTS can be similar to those of other conditions, such as low blood pressure (NHS PoTS guidance), and its palpitations page lists other causes, such as iron deficiency anemia, an overactive thyroid, and heart rhythm problems (NHS heart palpitations guidance).

A dated log helps your team see whether palpitations line up with standing up, or come at other times as well.

For first-hour mornings, see what to log on POTS morning spike days.

In POTS Journey, the Daily check-in keeps palpitations on the same day as other upright symptoms.

What to log about how they feel

The NHS says that with palpitations your heartbeat feels uncomfortable or unusual, and you may feel it in your chest, neck, or throat (NHS heart palpitations guidance). It says your heartbeat may feel like it is racing or beating very fast; irregular, with skipped or extra beats (ectopic beats); pounding or thumping; or fluttering (NHS heart palpitations guidance).

Use those four words in your log, since they are the ones a clinician is likely to recognize. Note where you felt it, in the chest, neck, or throat, and whether it felt the same each time or changed.

Write the entry as soon as you can, in your own words, before the details fade. A short line, such as "fluttering in the throat, 2 minutes, after standing from the sofa", is enough to build a pattern over a few weeks.

In POTS Journey, the Daily Journal keeps each description in your own words, with its date.

What to log about timing and position

The NHS says palpitations can last seconds, minutes, or longer (NHS heart palpitations guidance). With PoTS, it lists standing or sitting upright for long periods of time among the things that can make symptoms worse, and notes that a GP may check your blood pressure and heart rate before and after you stand up (NHS PoTS guidance).

For each episode, log the time of day, roughly how long it lasted, and what position you were in just before: lying down, sitting, just stood up, or standing for a while. Note whether it eased when you sat or lay down, since the NHS describes that pattern for PoTS symptoms that happen on standing (NHS, PoTS).

If you take heart rate readings, write the number next to the position. Over a week, the log shows whether most episodes cluster in the morning or after standing.

For tests that record this, see what to write in a POTS Holter monitor diary.

In POTS Journey, the Flare Tracker marks heavier days so they stand out in the history.

What to log about possible triggers

The NHS lists common causes of palpitations as strenuous exercise, lack of sleep, stress and anxiety, medicines, and alcohol, caffeine, nicotine, and recreational drugs (NHS heart palpitations guidance). It says avoiding things that can trigger palpitations, such as stress, smoking, caffeine, and alcohol, can help if palpitations are not caused by a health condition (NHS heart palpitations guidance).

Its PoTS page lists getting too hot, eating, especially carbohydrates like white bread, pasta, and rice, not drinking enough fluids, drinking alcohol, resting too much, exercise, and being on your period among the things that can make PoTS symptoms worse (NHS PoTS guidance). It advises not drinking too much caffeine or alcohol (NHS PoTS guidance).

So log the night's sleep, caffeine and alcohol, meals, fluids, heat, and any exercise on the same day as each episode.

For alcohol days, see how alcohol stacks with POTS standing and heart rate.

In POTS Journey, the Food Tracker keeps meals and drinks beside how you felt afterwards.

What to log about medicines

The NHS lists medicines among the common causes of palpitations and says to check the leaflet that comes with the medicine (NHS heart palpitations guidance). For PoTS, it says you may be prescribed medicines to help control your symptoms, such as fludrocortisone (a steroid), and medicines used to treat heart conditions and manage your blood pressure, such as beta blockers, and that you may need to try several different medicines or combinations of medicines (NHS PoTS guidance).

Log every medicine with its name, dose, and start date, and note any change. If palpitations start or change in the same week as a new medicine, the dates make that easy to see, and you can raise it with the doctor or pharmacist.

Keep taking a prescribed medicine unless your doctor or pharmacist advises otherwise, and bring the log to that conversation rather than changing doses yourself.

In POTS Journey, My Meds keeps each medicine with its start date, so changes can be lined up against episodes.

Tests and when to get help

The NHS says you may have an electrocardiogram (ECG) to help find out what the cause of palpitations might be, a test where small pads are stuck to your skin to check the electrical signals from your heart, and you may be referred to a heart specialist (cardiologist) (NHS heart palpitations guidance). For PoTS, a specialist may use heart and blood pressure tests such as an echocardiogram, an ECG, and 24-hour blood pressure and heart rate monitoring (NHS PoTS guidance).

The NHS advises seeing a GP if palpitations keep coming back or happen more often, last longer than a few minutes, or if you have a heart condition or a family history of heart problems (NHS heart palpitations guidance).

It says to call 999 or go to A&E if you have palpitations that do not go away, or palpitations with chest pain, shortness of breath, or feeling faint or fainting, and not to drive yourself (NHS heart palpitations guidance). If those symptoms have stopped, it says to ask your GP surgery for an urgent appointment or call 111 (NHS heart palpitations guidance). A log never replaces that help. In the US, call 911 or go to the ER for these signs, and use urgent care or your primary care doctor where the NHS mentions a GP.

In POTS Journey, the Doctor Report brings your dated episodes to the appointment.

How POTS Journey can help

One episode is easy to describe vaguely. The harder part is keeping how it felt, how long it lasted, your position, and the day's triggers in one dated record, so your team can see the pattern.

POTS Journey is a personal POTS tracker from Health Journey Labs on the App Store and Google Play. It records symptoms, heart rate notes, medicines, and tests in one dated history. For a side-by-side look at POTS trackers, see the best POTS apps in 2026. Below is what you can use and how each part helps:

• My Meds — Medicine names and timing, such as beta blockers, midodrine, or fludrocortisone, so you can see how a start date lines up with standing tolerance.
• Daily check-in — A short guided pass across symptoms, mood, nutrition, sleep, exercise, meds, and external factors, including dizziness, heart rate spikes, salt intake, dehydration, heat, and fog.
• Flare Tracker — Mark a day clearly worse than your usual hard week, with a category, intensity, and duration, so you can tell a one-off spike from a pattern.
• Daily Journal — Freer notes, including voice when fog or fatigue makes typing hard, such as how you felt after exercise or notes after a visit.
• Weekly Goals — Set one small aim, such as a glass of water before getting up or a short recumbent workout three times a week, and see whether it held.
• Food Tracker — Meal or drink lines when meals, caffeine, alcohol, or salt and fluid timing come with worse upright or fog days.
• AI companions — Clara and specialist companions already see your logged history, which helps with visit wording or pacing ideas.
• Doctor Report — Two views: the Appointment Planning Report, a list of questions to prepare before a visit, and Generate Report, a dated summary of your recent progress to show a doctor saved in My Care Team.
• My Labs — Result dates for tilt-table notes, blood counts, iron, thyroid, or other tests, so each result sits next to how you felt that month.
• My Care Team — A profile for each clinician, plus visit notes used before, during, and after appointments.
• Learn — Short education topics on standing tolerance, exercise done lying or sitting down (recumbent exercise), pacing, and visit preparation.
• Weight Tracker — Weight entries when weight or fluid shifts are part of what you and your clinician are watching.
• Period Tracker — Cycle dates and flow, so you can line up cycle timing with upright symptoms or heat weeks.
• My Assessments — Structured check-ins that add context about you across weeks.

Everything you log builds one history. Guided forms include the key questions, and you can add custom symptoms when you need your own labels. POTS Journey is free to download.

Sources

• NHS — Postural tachycardia syndrome (PoTS)
• NHS — Heart palpitations

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