MS and heart palpitations: what to know

Palpitations can feel like fluttering, pounding, skipped beats or a heartbeat that suddenly seems fast. The sensation may occur while resting or moving. A clinician will consider the timing, rhythm and accompanying symptoms rather than assuming that MS is the cause.

MS can affect nerve pathways that help regulate automatic body functions, but palpitations can also arise from factors unrelated to MS. Heat, illness, poor sleep, emotional stress, dehydration, stimulant drinks and some medicines can change how forcefully or quickly the heart beats.

Other possibilities include an overactive thyroid, low blood sugar, anaemia or an abnormal rhythm such as atrial fibrillation. Breathlessness, swelling or reduced exercise tolerance may point to a different heart problem and should not be attributed to MS without an examination.

Record when an episode starts, how long it lasts, what you were doing, and whether the beat feels regular or uneven. Note dizziness, chest discomfort, breathlessness, fever, new weakness or changes after a medicine dose. This record can help a clinician decide whether you need an ECG, blood tests or longer heart-rhythm monitoring.

Take prescribed medicines as directed and do not stop an MS treatment or heart medicine suddenly. Until you have advice, avoid excess caffeine, nicotine and non-prescribed stimulant products, and drink fluids normally unless you have been told to restrict them.

Seek emergency help now if palpitations come with chest pain or pressure, severe breathlessness, fainting, collapse, or a new severe neurological symptom. These features can signal a serious problem and should not be explained away as an MS symptom.

Arrange prompt medical review if episodes keep returning, last longer than usual, begin after a medicine change, or occur with light-headedness, unusual fatigue or reduced ability to exercise. A clinician can check your pulse, blood pressure, medicines and possible causes such as dehydration, hypoglycaemia or thyroid disease.

Ask whether the pattern suggests a heart-rhythm problem, whether any MS or other medicine could contribute, and whether you need an ECG or blood tests. Also ask which symptoms should prompt emergency care and whether your usual activity, caffeine intake or fluid plan should change.