Cold hands and palpitations: what to know

Palpitations are sensations such as pounding, racing, fluttering or skipped beats. Adrenaline can produce a faster heartbeat and cooler hands during fear, pain or exertion. Dehydration, fever, caffeine, nicotine, some medicines and low blood sugar can do something similar. Anaemia, an overactive thyroid or an abnormal rhythm such as atrial fibrillation may also present with palpitations. The symptom pattern does not diagnose any one condition.

Note whether the rhythm feels regular or irregular, how suddenly it starts and stops, what you were doing, and whether dizziness, chest discomfort, breathlessness or fainting occurs. A pulse check during an episode can be useful, but do not delay urgent care to measure it.

Stop strenuous activity, sit or lie safely, breathe slowly, and loosen tight clothing. Sip water if you can, and follow your diabetes plan if low blood sugar is a known risk. Avoid caffeine, nicotine, alcohol and non-prescribed stimulants until the cause is clearer. Arrange a medical review for new, repeated or prolonged palpitations, especially if you have heart disease, anaemia or thyroid symptoms.

Call emergency services for palpitations with chest pain, severe breathlessness, fainting, confusion, marked weakness, or a cold, pale or blue limb. Urgent assessment is also needed for a fast or irregular heartbeat that does not settle with rest, or symptoms after a new medicine. Do not drive yourself if you feel faint or unwell.

Ask whether you need an ECG, blood tests for anaemia or thyroid function, or a longer rhythm monitor. Discuss hydration, medicines, caffeine, menstrual or other blood loss, and episodes linked to meals. Ask which symptoms should lead you straight to emergency care.