Headaches and heart palpitations: what should you know?

Palpitations can feel like racing, fluttering, pounding or skipped beats. Triggers include anxiety, poor sleep, caffeine, nicotine, dehydration and missed meals. Anaemia, iron deficiency anaemia and an overactive thyroid can also produce a fast heartbeat with headache or weakness. Atrial fibrillation is one rhythm problem a clinician may consider; heart failure is another condition requiring assessment when breathlessness or swelling is present. Note whether the pulse feels regular, how long episodes last, and what you were doing when they started.

Stop exertion, sit down and breathe slowly. Sip water if you may be dehydrated, eat a usual meal if you have missed one, and avoid caffeine, nicotine, energy drinks and decongestants until the episode settles. Do not drive if you feel faint. Arrange a clinical review if episodes recur, disturb sleep, or come with fatigue, weight change, tremor or breathlessness; an examination, blood tests or an ECG may be appropriate.

Call emergency services for palpitations with chest pressure, severe breathlessness, fainting, new weakness, trouble speaking, confusion or a sudden severe headache. Seek urgent assessment if the heartbeat remains very fast or irregular, or if symptoms continue despite rest. A new neurological symptom should be treated as urgent rather than attributed to anxiety.

Ask whether you need an ECG, blood count, thyroid testing or glucose check, and whether any current medicine can trigger palpitations. Share your pulse notes, known medical conditions, stimulants and family history of rhythm problems.