Dizziness with Palpitations

Overview

Dizziness that comes with palpitations — a racing, irregular or pounding heartbeat — can occur when a rhythm problem briefly reduces blood flow to the brain. It can also come from low blood pressure, dehydration, anaemia or anxiety. The combination is assessed promptly, particularly when the dizziness is a near-faint or comes with chest discomfort or breathlessness. This page covers the combined presentation; the general dizziness symptom is covered under Migraine, Headache & Neurological Symptoms.

Common causes

• Rhythm problems — fast or slow arrhythmias that briefly reduce blood flow to the brain.
• Low blood pressure on standing (orthostatic hypotension).
• Dehydration and anaemia.
• An over-active thyroid.
• Anxiety and hyperventilation.
• Medication effects — especially blood-pressure tablets.
• Low blood sugar.

Symptoms and associated features

The key details are whether the dizziness is a spinning sensation, a near-faint, or unsteadiness; whether it comes on standing; and whether it accompanies a clearly fast, slow or irregular pulse. Dizziness that is a near-faint with palpitations, or that comes with chest discomfort or breathlessness, needs prompt assessment.

Evaluation and investigations

Evaluation combines a history and examination — including lying and standing blood pressure — with an ECG and blood tests (complete blood count, thyroid function, electrolytes, blood sugar). A Holter monitor is arranged when a rhythm problem is intermittent. See ECG Evaluation for Symptoms, Dizziness and Abnormal Test Results.

Management overview

Management treats the cause. Rhythm problems are managed with rate or rhythm control; low blood pressure is addressed with hydration, posture and medication review; anaemia and thyroid disorders are treated; and anxiety-related dizziness is managed with reassurance and treatment of anxiety.

Follow-up and monitoring

Follow-up confirms the episodes have settled and any underlying cause is controlled. Persistent or worsening symptoms are reviewed and referred for specialist assessment when appropriate.

Warning signs — seek urgent care

• Dizziness with palpitations and actual fainting — urgent.
• Dizziness with chest pain, breathlessness or a rapid irregular pulse — urgent.
• Dizziness with weakness on one side of the body or slurred speech — possible stroke; emergency.
• Dizziness with collapse or loss of consciousness — emergency.

How we help

Dr. Nayak evaluates dizziness with palpitations with a structured history, lying and standing blood pressure, an ECG and targeted blood tests, treats the underlying cause, and refers for specialist cardiac or neurological care when needed. Consultations are available in-clinic in Bhubaneswar and over teleconsultation.

Related conditions and patient concerns

• Feeling Faint with Palpitations
• Palpitations
• Dizziness
• Lightheadedness
• ECG Evaluation for Symptoms