Feeling cold and heart palpitations: what it can mean

Feeling cold with heart palpitations may be temporary, but new, prolonged or severe symptoms should be medically assessed. Palpitations can feel like racing, pounding, fluttering or skipped beats, while coldness may reflect circulation, stress or another body response.

Anxiety, dehydration, fever, caffeine, nicotine, poor sleep and missed meals can trigger noticeable heartbeats and a cold or shaky feeling. Hypoglycaemia may cause sweating, trembling, hunger, weakness or confusion. Anaemia, including iron deficiency anaemia, can make the heart work harder and may accompany tiredness, breathlessness or pale skin. Hyperthyroidism can cause a fast heartbeat, heat intolerance and weight change, while atrial fibrillation may cause an irregular rhythm. Heart failure is associated with breathlessness, swelling and reduced exercise tolerance. These patterns guide assessment; they do not diagnose the cause.

Stop strenuous activity, sit down and breathe slowly. Note when the episode began, whether the rhythm feels regular, and what you had eaten or consumed beforehand. Drink water if you can and eat a small snack if you may have missed food and are alert enough to swallow. Avoid caffeine, nicotine and decongestants until you have advice. Book a medical appointment for repeated episodes or symptoms with fatigue, breathlessness, faintness or weight change.

Call emergency services for palpitations with chest pain, severe breathlessness, fainting, collapse, new confusion or a sustained very fast or irregular heartbeat. Seek prompt care if an episode is new and does not settle, or if you have known heart disease. Do not drive while faint, confused or severely short of breath.

Could I need an ECG or blood tests for anaemia, thyroid function or glucose? Are any of my medicines or supplements contributing? How should I record my pulse and what result needs urgent attention?