Caffeine and heart palpitations: what should you know?

Caffeine stimulates the nervous system and may increase the sensation of pounding, fluttering or skipped beats. The effect can be stronger with energy drinks, poor sleep, stress, dehydration or taking caffeine quickly. Palpitations are a symptom, not a diagnosis. They may occur with anxiety, anaemia, low blood sugar, an overactive thyroid or an abnormal rhythm such as atrial fibrillation. A feeling linked to caffeine does not prove caffeine is the cause, and palpitations can happen without caffeine.

Pause caffeine and note when the sensation starts, how long it lasts, whether the rhythm feels regular, and what you were doing. Avoid energy drinks and other stimulants while you are assessing the pattern. Drink fluids, eat regular meals and sleep consistently. Do not stop a prescribed heart medicine or thyroid medicine without advice. A clinician may need to examine you, review medicines and arrange a heart rhythm check, particularly when episodes recur.

Call emergency services for palpitations with chest pain, severe breathlessness, fainting, new weakness or confusion, or an episode that does not settle. Seek prompt medical advice for repeated episodes, a very irregular rhythm, or palpitations with dizziness. Arrange review if you have known heart disease, thyroid disease or anaemia, even when episodes seem related to caffeine.

Ask whether you need an ECG or rhythm monitor, whether any medicine or illness could be contributing, and how to reduce caffeine without worsening symptoms.