If a patient wakes up in bed with a rapid heartbeat and palpitations, there are several possibilities: 1. Endocrine metabolic diseases, such as hyperthyroidism and hyperadrenocorticism, can cause patients to wake up in bed with panic and palpitations. 2. In some cases of cardiac neurosis, if the patient wakes up with nightmares during sleep, there will be panic and palpitations. 4, some organic heart diseases, such as coronary heart disease, arrhythmia, unstable angina, myocarditis, etc., will also have the above clinical manifestations.