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When heart palpitations and headache occur together

Phil Day: Superintendent Pharmacist | minute read
A doctor placing a stethoscope on a man's chest.

Heart palpitations and headaches are two common symptoms that most people will experience at some time; they can occur on their own, with other symptoms, or together.

Heart palpitations are heartbeats that are more noticeable than normal and may involve a fluttery sensation in the chest or a more rapid heartbeat, which can cause worry.

Occasionally, headaches and heart palpitations may occur together. In most cases, this is nothing to be concerned about; here we’ll look at some potential causes, ways to manage these symptoms, and when it may be time to speak to your doctor.

What causes palpitations and headaches to occur together?

The underlying reasons might be linked, or they might be unrelated, but there are several possible reasons why you may be experiencing heart palpitations and headaches together.

Medications

One potential cause is as a side effect of a medicine, or a combination of medicines, you might be taking.

“Vasodilator” medicines - which are often prescribed for the management of high blood pressure (hypertension) or heart failure – can sometimes cause side effects including both headaches and heart palpitations, as well as nausea, vomiting and chest pain.

Another drug prescribed for the management of high blood pressure (hypertension), called nifedipine, can also cause both symptoms, as well as others including nausea, fatigue and dizziness. 

How to manage medication side effects

If you have been prescribed one of these medicines, and experience any unpleasant side effects, talk to your doctor or pharmacist. You can report side effects to the Yellow Card Scheme which helps the Government’s medicines safety agency identify, collate and address trends. If you feel that you want to stop taking any medicine, you should talk to your doctor first.

Dehydration 

Water plays a key role in maintaining your overall health and wellbeing. Dehydration can occur for several reasons, the simplest of which is that you are simply not drinking enough water. However, it can also occur if you have recently been unwell, especially if the illness involved vomiting and diarrhoea. It can also be caused by excessive exercise and sweating. 

Dehydration can cause both headaches and heart palpitations. You may also experience muscle cramps, feel thirsty, feel dizzy or lightheaded and tired.

How to manage dehydration

Management of dehydration involves drinking plenty of fluids that are free from caffeine or alcohol.

If you have been unwell, you need to replenish the water, salts and sugars lost from your body. Talk to your pharmacist or doctor and they will be able to recommend the best form of oral rehydration therapy to help you, which may be in the form of rehydration sachets that are mixed with water. However, if you are unsure what has caused your dehydration, there may be an underlying cause and you should speak with your doctor who may recommend some further tests.

Caffeine and alcohol 

Beverages that contain caffeine or alcohol can induce headaches and heart palpitations.

Caffeine is found in drinks such as tea, coffee, and energy drinks, and can make you feel more awake and alert. Consuming caffeine in moderation doesn’t cause harm but it can cause some side effects, in addition to headaches and heart palpitations, such as feeling restless, dizziness and can cause feelings of anxiety. 

Both symptoms may also be caused by alcohol consumption, particularly when consumed in excessive amounts, which can lead to dehydration.  

How to manage coffee and alcohol consumption

Both caffeine and alcohol are drugs, and if the cause of your heart palpitations is likely to be from drinking too much of either, the best way to manage this is to limit your intake. 

You could also consider looking for alternative drinks such as water, alcohol-free beers or wine, or decaffeinated tea or coffee.

If your symptoms persist, there may be an underlying cause. Consult with your doctor if you are unsure.

Heart arrhythmia 

If you have been diagnosed with a heart arrhythmia (an abnormality of the heart rhythm), you may be susceptible to heart palpitations. If you have a history of heart problems or have been diagnosed with arrhythmia, you should speak to your doctor if you experience palpitations and headaches and are concerned. Have a read through the NHS guide to heart arrhythmias for more information.

How to manage heart arrhythmia

If you have a diagnosed heart condition or if you are unsure what is causing your symptoms, you should talk to your doctor and they will be able to advise further and conduct some diagnostic checks.

Anxiety  

With anxiety, the person may feel excessive, uncontrolled feelings of worry and this may be accompanied by panic attacks. Anxiety can sometimes also cause several physical symptoms.

Physical symptoms can include both headaches and heart palpitations, and also:

- Chest pain or discomfort
- Feeling dizzy or faint
- Sweating, trembling or shaking

How to manage anxiety

If your headaches and palpitations are accompanied by or triggered by anxiety, you should speak to your doctor and they will be able to advise you further.

Treatment options can include:
- Talking therapy (such as CBT or psychotherapy)
- Occasionally, medication may be recommended to help you manage

The related headaches and heart palpitations can also be prevented by avoiding stressful situations that could trigger your anxiety.

Stress 

Another possible cause of this combination of symptoms is stress. If you have been particularly stressed recently, it may be that this is linked to your experience of headaches and heart palpitations. 

How to manage stress

A degree of stress is normal, but excessive stress can be caused by a variety of pressures in your day-to-day life and may cause other symptoms in addition to headaches and heart palpitations. If you think stress is causing your symptoms, you can try some self-management techniques such as:
- Exercising
- Talk to someone you trust about your problems
- Do something relaxing like go for a walk or take a bath
- Make time for your hobbies
- Spend time with friends and family

Anaemia 

Anaemia is a common condition in which the number or the quality of the red blood cells in the body is decreased, leading to less oxygen being delivered to the cells. This can lead to several potential symptoms including: 
- Headaches
- Heart palpitations
- Chest pain
- Cold extremities
- Weakness
- Lightheadedness
- Pale skin or jaundice

It can be caused by an inadequate diet that is deficient in iron, folic acid or vitamin B12, or by significant blood loss following surgery or injury. It can also be caused by a chronic disease such as an infection, liver or kidney disease, cancer or autoimmune disease. 

How to manage anaemia

If you think you could be anaemic, you should see your doctor and they will conduct a simple blood test to determine if this is the case and determine what type of anaemia you have.

If you have iron-deficiency anaemia,  you will be prescribed oral iron supplements to replenish your iron stores. In this case, there are some things you can do at home to help such as:
- Eating more dark green vegetables
- Eating more meat, beans, peas and lentils
- Eating more cereal and bread with extra iron in them
- Reducing your intake of tea, coffee, milk and dairy products

If your anaemia is caused by folic acid or vitamin B12 deficiency, you may be treated with oral folic acid tablets or vitamin B12 injections.

It may also help to include more vitamin-rich foods in your diet such as:
- Eating more meat, fish, dairy and eggs which are rich in vitamin B12
- Eating more green vegetables which are rich in folic acid

When should you see a doctor?

There are some instances in which it would be advisable for you to contact a doctor. Headaches and heart palpitations can be caused by several factors and in many cases, they will ease with time or with the recommendations mentioned above. However, should these two symptoms occur together alongside shortness of breath, chest pain, losing consciousness (passing out, fainting), or if you experience confusion, you should contact your doctor immediately.

You should also contact your GP regarding your headache if: 
- Your headache keeps coming back
- You feel sick, vomit or find noises or bright lights painful to be around
- You have  severe pain at the front or side of your head which may indicate a migraine

You should contact your GP regarding your heart palpitations if: 
- The palpitations last a long time, do not go away or get worse
- You have a history of heart problems
- You are concerned about the palpitations for any other reason

NHS advice

For more general health advice about these symptoms and many other conditions, visit the NHS website.