Dizziness and Heart Palpitations: What Can Cause Both?
Feeling your heart race, pound, flutter or skip beats while also feeling dizzy can be unsettling. Sometimes both symptoms share the same cause, such as a heart-rhythm problem, low blood pressure, dehydration or anemia.
In other situations, the dizziness may come from a completely different problem — such as an inner-ear disorder — while the heartbeat awareness has another explanation. The type of dizziness and the symptoms occurring with it help determine what should be investigated.
Are Dizziness and Heart Palpitations Related?
- Yes, they can be. Some heart-rhythm disorders can cause both palpitations and dizziness or lightheadedness.
- Low blood pressure or orthostatic hypotension may cause dizziness, weakness and palpitations, especially after standing.
- Dehydration, anemia and illness can affect circulation or heart rate and may cause both symptoms.
- Stress, anxiety or panic can cause a racing or pounding heartbeat together with lightheadedness.
- Inner-ear disorders can cause vertigo, but they do not automatically explain recurrent palpitations.
- Palpitations with fainting, chest pain, severe shortness of breath or severe dizziness need urgent medical attention.
What Do You Mean by “Dizziness”?
Dizziness is not one specific sensation. Describing exactly what you feel can help your doctor narrow down the possible causes.
You may feel faint, weak, “woozy” or as though you might pass out.
When this occurs together with palpitations, blood pressure, heart rate and heart rhythm are particularly important to assess.
Vertigo is a spinning or moving sensation — either you feel that you are moving or that your surroundings are moving.
Inner-ear disorders are an important cause of true vertigo.
You may feel unstable while standing or walking without necessarily feeling faint or experiencing spinning.
Balance, neurological, medication and other medical causes may need consideration.
Does the Palpitation Always Cause the Dizziness?
No.
Sometimes an abnormal heart rhythm can affect how effectively the heart pumps blood, leading to lightheadedness or near-fainting. In that situation, the palpitations and dizziness may be part of the same cardiovascular event.
But dizziness can also come from low blood pressure, dehydration, anemia, medications, an inner-ear disorder or another medical condition.
For this reason, it is not accurate to assume that every episode of dizziness occurring with palpitations is simply “caused by the palpitations.”
What Can Cause Dizziness and Heart Palpitations Together?
Heart Arrhythmias
Fast, slow or irregular heart rhythms may cause palpitations together with dizziness, lightheadedness, weakness or fainting.
Low Blood Pressure
Blood pressure that becomes too low may cause dizziness or fainting. Some people also notice palpitations, weakness or blurred vision.
Dehydration
Significant fluid loss can contribute to lightheadedness and a rapid heartbeat, particularly during illness, heat exposure, vomiting or diarrhea.
Anemia
Anemia can cause fatigue, weakness, shortness of breath, dizziness and a fast or noticeable heartbeat.
Stress, Anxiety & Panic
Anxiety can increase heart rate and breathing rate and may produce palpitations, trembling and lightheadedness.
New symptoms should not automatically be labelled as anxiety before appropriate evaluation.
Caffeine & Other Stimulants
Caffeine, nicotine, energy drinks and some medicines may affect heart rate or make palpitations more noticeable.
See our guide to caffeine and heart palpitations .
When Can a Heart-Rhythm Problem Cause Dizziness?
Palpitations are the sensation of being aware of the heartbeat. As explained in our heart palpitation symptoms guide , they may feel like racing, pounding, fluttering, skipped beats or an irregular heartbeat.
Some arrhythmias can cause both palpitations and dizziness. Examples include certain tachycardias, atrial fibrillation and rhythms that are unusually slow.
Fast Heart Rhythms
A very rapid rhythm can sometimes reduce the heart’s ability to fill efficiently between beats, producing lightheadedness or weakness.
Irregular Rhythms
Atrial fibrillation and other irregular rhythms can cause palpitations together with fatigue, breathlessness or dizziness in some patients.
Slow Heart Rhythms
A heart rate that is too slow for the person’s needs can sometimes cause dizziness, weakness or fainting.
Learn more about bradycardia and palpitations .
Dizziness and Palpitations When Standing Up
If the symptoms begin after you stand from a chair or get out of bed, changes in blood-pressure or heart-rate regulation may be relevant.
Orthostatic hypotension occurs when blood pressure falls more than expected after standing. It commonly causes dizziness or lightheadedness and can sometimes be associated with palpitations.
Another condition, postural orthostatic tachycardia syndrome (POTS), involves an excessive heart-rate response to upright posture in the appropriate clinical setting.
If your symptoms begin primarily after sitting quietly rather than when standing, see our guide to heart palpitations while sitting .
Your doctor may compare your blood pressure and pulse while lying, sitting and standing when an orthostatic problem is suspected.
What About Inner-Ear Problems?
Inner-ear disorders are important causes of vertigo and balance problems.
For example, Ménière’s disease can cause episodes of vertigo together with tinnitus, hearing loss and a feeling of fullness in the affected ear.
Labyrinthitis and other vestibular disorders can also produce significant dizziness or vertigo.
However, an inner-ear diagnosis does not automatically explain heart palpitations.
A frightening vertigo attack may trigger anxiety or a stress response that makes the heartbeat more noticeable, but recurrent palpitations may still have an independent cardiac or medical cause.
If your dizziness feels like spinning and is accompanied by hearing loss, tinnitus or ear fullness, tell your healthcare professional because this pattern may point toward a vestibular cause.
Pay Attention to When the Symptoms Occur
During Exercise
Palpitations associated with significant dizziness or near-fainting during exercise deserve particular attention.
See heart palpitations after exercise for more information.
With Weakness
Dizziness, palpitations and weakness together may occur with dehydration, anemia, low blood pressure or other medical conditions.
Read our guide to heart palpitations and weakness .
Repeated Throughout the Day
Palpitations occurring frequently or almost continuously deserve evaluation rather than being repeatedly dismissed as stress.
With Chest Discomfort
Chest discomfort changes the level of concern, particularly when it is new, severe, associated with exertion or accompanied by breathlessness.
Read more about chest pain and palpitations .
How Are Dizziness and Palpitations Evaluated?
Evaluation depends on the type of dizziness, the palpitation pattern, associated symptoms and your medical history.
Medical History
Your doctor may ask whether you feel lightheaded, faint, spinning or unsteady; what the heartbeat feels like; how long the symptoms last; and what you are doing when they begin.
Blood Pressure & Pulse
Heart rate, rhythm and blood pressure may be checked, including measurements after position changes when appropriate.
ECG / EKG
An electrocardiogram records the heart’s electrical activity and can identify many rhythm abnormalities if they are occurring during the test.
Holter or Event Monitoring
If symptoms come and go, longer heart-rhythm monitoring may help capture what the heart is doing during an actual dizzy or palpitation episode.
Blood Tests
Depending on the clinical situation, your doctor may consider tests for anemia, thyroid abnormalities, electrolytes, glucose or other causes.
Other Testing When Appropriate
Echocardiography or other cardiac investigations may be appropriate when heart disease is suspected. Vertigo with hearing symptoms may instead require vestibular or ENT assessment.
What Should You Do When You Feel Dizzy and Have Palpitations?
Do not stop prescribed medication or begin heart medication or supplements solely because of information on this page. Medication changes should be discussed with an appropriate healthcare professional.
“Dizzy” Is One of the Most Important Words to Clarify
When a patient tells me, “I feel dizzy when my heart starts pounding,” I first ask exactly what dizziness means to that person.
Feeling as though you may faint is different from feeling that the room is spinning. That distinction can send the evaluation in very different directions.
I also want to know whether the patient was standing, exercising or resting; whether the heart felt fast or irregular; how long the episode lasted; and whether there was chest discomfort, breathlessness or loss of consciousness.
The goal is not simply to treat two symptoms. It is to understand whether they share one cause or whether two different problems are occurring at the same time.
When Should You Arrange a Medical Check?
Talk with your healthcare professional if dizziness and palpitations:
- Are new or unexplained
- Keep returning
- Are becoming more frequent
- Last longer than before
- Occur during exercise
- Begin consistently after standing
- Are associated with unusual weakness or significant fatigue
- Occur when you already have heart disease or an arrhythmia
- Interfere with normal daily activities
When Dizziness and Palpitations Need Urgent Care
Seek urgent or emergency medical care if palpitations and dizziness occur with:
- Fainting or loss of consciousness
- Chest pain or significant chest pressure
- Severe shortness of breath
- Severe or rapidly worsening dizziness
- Feeling that you are about to pass out
- Sudden severe weakness
- New confusion or other severe neurological symptoms
Do not assume these symptoms are caused by anxiety, dehydration or an inner-ear problem without appropriate medical assessment.
Dizziness and Heart Palpitations: FAQs
Why am I dizzy when my heart starts racing?
A very fast heart rhythm can sometimes affect how efficiently the heart pumps, which may cause lightheadedness. However, dehydration, low blood pressure, anxiety and other medical conditions may also cause both symptoms.
Can low blood pressure cause palpitations and dizziness?
Yes. Low blood pressure can cause dizziness, lightheadedness or fainting, and some people also experience palpitations.
Can dehydration cause dizziness and a fast heartbeat?
Yes. Significant dehydration can produce dizziness or lightheadedness together with a rapid heartbeat.
Can an inner-ear problem cause heart palpitations?
Inner-ear disorders can clearly cause vertigo and balance symptoms, but they do not automatically explain recurrent heart palpitations.
Anxiety or stress during a severe vertigo episode may make the heartbeat more noticeable, but the palpitations may still require separate evaluation.
Why do I get dizzy and have palpitations when I stand up?
Orthostatic hypotension and other forms of orthostatic intolerance may cause symptoms after moving upright. Your doctor may compare your heart rate and blood pressure in different positions.
Can anxiety cause both symptoms?
Yes. Anxiety and panic can cause a rapid or pounding heartbeat, changes in breathing and lightheadedness. But new or concerning episodes should not automatically be attributed to anxiety without considering other causes.
Can I have an arrhythmia even if my ECG was normal?
Yes. An intermittent arrhythmia may not occur during a short office ECG. Longer ambulatory rhythm monitoring may help capture the heart rhythm during symptoms.
Is dizziness with palpitations dangerous?
Not always, but the combination deserves more attention than an isolated brief palpitation. Fainting, chest pain, severe shortness of breath or severe dizziness are warning signs that require urgent assessment.
Continue Reading
Evidence Used for This Article
- American Heart Association. Symptoms, Diagnosis and Monitoring of Arrhythmia .
- National Heart, Lung, and Blood Institute. Arrhythmias: Symptoms .
- National Heart, Lung, and Blood Institute. Atrial Fibrillation: Symptoms .
- Cleveland Clinic. Orthostatic Hypotension .
- Cleveland Clinic. Postural Orthostatic Tachycardia Syndrome (POTS) .
- National Institute on Deafness and Other Communication Disorders. Ménière’s Disease .
- MedlinePlus. Dehydration .
- Mayo Clinic. Heart Palpitations: Symptoms and Causes .