Heart palpitations, described as a sudden fluttering, pounding, or racing sensation in the chest, and headaches are common symptoms that frequently occur together. While a palpitation event does not always directly cause a headache, the connection is rooted in shared physiological pathways and underlying health conditions affecting both the cardiovascular and nervous systems.
Understanding Symptom Connection
A palpitation event can directly initiate a headache through rapid changes in circulation. When the heart rate suddenly speeds up or becomes irregular, such as during an arrhythmia, the heart’s efficiency at pumping blood may temporarily decrease. This change in cardiac output can disrupt blood pressure, triggering vascular reactions in the head.
The brain is sensitive to shifts in blood flow and oxygen supply. A sudden drop in blood pressure or a rapid heart rate increase activates the body’s compensatory mechanisms, involving the constriction and subsequent dilation of blood vessels in the brain (vasoconstriction or vasodilation). This hemodynamic instability is a physiological trigger for various headaches, including migraines or tension-type headaches. In rare instances, a severe cardiac event can cause a headache known as cardiac cephalalgia, where pain results from low cardiac output.
Shared Underlying Health Factors
The most frequent reason for the co-occurrence of heart palpitations and headaches is a shared underlying trigger impacting both the heart and the brain. The autonomic nervous system (ANS), which controls involuntary functions like heart rate and blood vessel diameter, is often the central link. Stress and anxiety activate the ANS, initiating the “fight-or-flight” response and releasing hormones like adrenaline and cortisol. These hormones increase heart rate, causing palpitations, and heighten muscle tension and vascular reactivity, leading to stress-related headaches.
Dehydration and electrolyte imbalances are common triggers, as the body requires adequate fluid volume for stable blood pressure and electrical conduction. Insufficient fluid reduces blood volume, causing the heart to beat faster to maintain circulation, which is felt as palpitations. This lower circulating volume also reduces blood flow to the brain, contributing to headache pain. Hormonal fluctuations, particularly involving estrogen and progesterone, can affect the heart’s electrical signaling and blood vessel elasticity, influencing both heart rhythm and susceptibility to migraines.
Conditions affecting the ANS, such as Postural Orthostatic Tachycardia Syndrome (POTS), frequently present with both symptoms due to an inability to regulate blood flow when standing up. In POTS, the excessive increase in heart rate when moving upright causes palpitations, accompanied by secondary headaches resulting from altered blood flow. Certain substances can also act as dual triggers. For example, medication side effects or withdrawal from stimulants like caffeine can directly impact the nervous system, resulting in an accelerated heart rate and vascular headaches.
Recognizing Urgent Symptoms
While many instances of co-occurring palpitations and headaches are benign, certain associated symptoms indicate a medical emergency requiring immediate attention.
Signs of Emergency
- Severe, crushing chest pain or discomfort alongside a racing heart.
- Sudden difficulty breathing or significant shortness of breath.
- Neurological symptoms, including sudden vision changes, slurred speech, confusion, or loss of consciousness (syncope).
- A headache described as the “worst headache of your life,” especially if it comes on abruptly, as this can signal a severe vascular event.