What Causes Palpitations With Breathlessness?

Palpitations with breathlessness most often come from a heart rhythm problem, a weak or stiff heart, or a non-heart trigger like anaemia, an overactive thyroid or anxiety. When the heart races or flutters, it can’t pump as smoothly, and the body responds by making you feel short of breath. The two symptoms together are worth taking seriously, because the cause can range from something easily fixed to a condition that needs prompt cardiac care.

According to Dr. S. A. Merchant, an Interventional Cardiologist and Advanced Heart Failure Specialist in Mumbai, “When a patient tells me the heart races and they also feel breathless, I ask myself two things. Is the rhythm the problem, or is the pump the problem? Sometimes it’s both. A racing heart can tire out a weak heart, and a weak heart can set off rhythm trouble. That’s why we shouldn’t treat these two symptoms in isolation.”

• Anaemia. With fewer red blood cells to carry oxygen, the heart beats faster and you get breathless more easily.
• Thyroid problems. An overactive thyroid can speed up the heart and bring on a pounding or irregular beat.
• Anxiety and panic attacks. Stress can cause a racing heart and a feeling of not getting enough air, though this should be confirmed only after the heart is checked.
• Other triggers. Fever, dehydration, lung problems, low body salts, too much caffeine or some medicines can do the same.

Because many people notice both symptoms during exertion, a stress test can show how your heart responds when it’s made to work harder.

• What shows up on your heart tracing. An ECG, and sometimes a Holter monitor, tells us whether the rhythm itself is abnormal.
• How the heart is pumping. An echocardiogram shows the heart’s pumping strength, valves and muscle.
• Blood test results. Haemoglobin, thyroid levels and body salts can reveal causes outside the heart.
• How severe and how frequent the symptoms are. Episodes with chest pain, dizziness or fainting need faster action than occasional mild ones

Key Takeaways

• Palpitations with breathlessness can come from the heart or from other conditions like anaemia, thyroid disease or anxiety.
• A racing heart can strain a weak heart, and a weak heart can trigger rhythm problems.
• Chest pain, fainting or severe breathlessness with a racing heart is an emergency.
• An ECG, Holter, echo and blood tests help find the cause.
• Don’t assume it’s just stress until the heart has been checked.

• The type of rhythm caught on testing. A harmless extra beat and atrial fibrillation are handled very differently.
• How your body responds. Dizziness, fainting, chest pain or breathlessness during episodes make evaluation more urgent.
• Any underlying cause. Treating a thyroid problem, BP, valve disease or heart weakness can settle the rhythm in some people.
• Your stroke risk and overall health. Age, other illnesses and the rhythm type decide whether medicines, procedures or just monitoring is best.

Key Takeaways

• An irregular heartbeat means the heart rhythm is too fast, too slow or uneven.
• Occasional skipped beats are common and often harmless.
• Frequent, long-lasting episodes, or ones with dizziness, breathlessness, chest pain or fainting, need a medical check.
• An ECG, and sometimes a Holter monitor, helps catch what a normal clinic visit can miss.
• Finding the cause is as important as treating the rhythm

References

1. Palpitations – StatPearls, NCBI Bookshelf
2. Arrhythmia – National Heart, Lung, and Blood Institute, NIH

Disclaimer

This blog is for general information and education only. It isn’t a substitute for personal medical advice, diagnosis or treatment. If you have chest pain, severe breathlessness or fainting, seek emergency care immediately.