Are Heart Palpitations Linked to Endometrial Cancer?

Heart palpitations (a feeling of a fast, fluttering, or pounding heartbeat) are not a typical direct symptom of endometrial cancer itself, but they can occur in people with endometrial cancer for several possible reasons related to the condition, its complications, or its treatments. ^[1] In most cases, palpitations are triggered by common factors like stress, anemia, medication effects, thyroid changes, or abnormal heart rhythms, and these can intersect with the cancer journey. ^{[2] [1]}

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What Palpitations Feel Like

Palpitations may feel like the heart is racing, skipping beats, or pounding, and they can be accompanied by chest discomfort, shortness of breath, dizziness, or lightheadedness. While usually benign, palpitations can sometimes signal an arrhythmia (irregular heartbeat) that needs medical evaluation. ^[1] If palpitations come with chest pain, trouble breathing, fainting, or persistent rapid heart rate, urgent care is advisable. ^{[2] [3]}

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Common Causes of Palpitations in the Context of Endometrial Cancer

1) Anemia from Cancer or Treatment

Cancer itself, heavy uterine bleeding, and chemotherapy can lead to anemia (low red blood cells), which reduces oxygen delivery and can make the heart beat faster to compensate, causing palpitations, shortness of breath, and fatigue. People receiving chemotherapy commonly develop anemia, which can drive symptoms such as palpitations. ^[4] Anemia often presents with tiredness, light‑headedness, pallor, and may warrant evaluation or transfusion depending on severity. ^[3]

2) Medication Side Effects (Chemotherapy and Immunotherapy)

Standard regimens for recurrent or metastatic endometrial cancer often include carboplatin and paclitaxel combined with immunotherapies like durvalumab or dostarlimab. These treatments can rarely cause heart problems, including chest pain, shortness of breath, swelling in the ankles, and an abnormal heartbeat. ^[5] Heart issues from these regimens are uncommon but potentially serious, and may occur within the first few months of therapy or even later. ^{[6] [7]} If you feel your heart racing during treatment especially with chest pain or breathlessness you should notify your team immediately or go to emergency care. ^[3]

3) Immune‑Related Endocrine Effects (Thyroid Disorders)

Checkpoint inhibitors (durvalumab, dostarlimab) can inflame endocrine glands and disrupt thyroid function. Hyperthyroidism (overactive thyroid) can cause a faster‑than‑usual heartbeat, heat intolerance, sweating, weight loss, and anxiety frequent triggers for palpitations. ^[8] Hypothyroidism (underactive thyroid) can also affect heart rate and overall energy, though tachycardia is more typical with hyperthyroidism. ^[8] Immune‑related endocrine side effects are recognized with these therapies, so thyroid testing is often part of monitoring. ^{[5] [8]}

4) Anxiety, Stress, Stimulants, and Electrolyte Issues

Even outside of cancer therapy, palpitations commonly stem from anxiety or panic, caffeine, nicotine, decongestants, diet pills, fever, or low electrolytes (like low potassium), and these factors can be heightened during cancer care. Such triggers are among the most frequent causes of palpitations in adults. ^[2] A medical review helps distinguish benign triggers from true arrhythmias. ^[1]

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When Palpitations Need Urgent Attention

• Chest pain, severe shortness of breath, fainting, or a sustained rapid heartbeat warrant immediate evaluation, as they can indicate serious heart problems or arrhythmias. Cancer treatment guides advise urgent assessment for these symptoms during therapy. ^[3] Persistent swelling of the ankles, worsening breathlessness, or new chest tightness can also be warning signs that require prompt reporting. ^{[5] [6]}

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How Your Care Team Evaluates and Manages Palpitations

Stepwise Assessment

• History and exam focusing on timing, triggers, and associated symptoms (chest pain, dyspnea, dizziness). This helps separate benign palpitations from those needing cardiology input. ^[1]
• Lab tests: complete blood count (to check for anemia), electrolytes (including potassium), and thyroid function. These are common contributors to palpitations and are routinely assessed. ^{[2] [4] [8]}
• ECG or rhythm monitoring: if palpitations are frequent, prolonged, or accompanied by concerning symptoms, testing can identify arrhythmias. Heart function testing may be recommended before or during certain cancer treatments. ^{[6] [7]}

Treatment Based on Cause

• Anemia: address bleeding, optimize iron or B12, consider erythropoiesis-stimulating agents when appropriate, or transfusion if severe. Anemia management improves symptoms like palpitations and fatigue. ^[4]
• Medication‑related: adjust or pause the offending drug, manage immune‑related toxicities per protocols, and involve cardio‑oncology as needed. Heart problems from cancer therapies, while uncommon, can be serious and require tailored intervention. ^{[6] [7]}
• Thyroid dysfunction: treat hyperthyroidism (e.g., beta‑blockers for fast heart rate and antithyroid strategies if indicated) or hypothyroidism (thyroid hormone replacement). Monitoring during immunotherapy helps catch these early. ^{[8] [5]}
• Lifestyle and triggers: reduce caffeine and nicotine, avoid decongestants with stimulants (like pseudoephedrine), manage stress, and correct electrolyte imbalances. These steps can markedly reduce benign palpitations. ^[2]

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Practical Tips for Someone With Endometrial Cancer Experiencing Palpitations

• Keep a symptom diary noting timing, triggers (caffeine, stress), and associated symptoms (shortness of breath, dizziness). This helps your team pinpoint causes and decide on tests. ^[1]
• Ask about anemia screening and thyroid checks during treatment, especially if you notice fatigue, cold/heat intolerance, or weight changes. These are common drivers of palpitations in this setting. ^{[4] [8]}
• Report new or worsening palpitations, chest pain, breathlessness, or ankle swelling right away during chemotherapy or immunotherapy. Early evaluation can prevent serious complications. ^{[3] [5] [6] [7]}

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Summary Table: Why Palpitations Can Occur During Endometrial Cancer Care

Potential cause	How it leads to palpitations	Typical clues	What to do
Anemia (cancer, bleeding, chemo)	Heart speeds up to deliver oxygen	Fatigue, pallor, lightheadedness	CBC, treat anemia; transfusion if severe [4] [3]
Cancer therapy cardiotoxicity	Abnormal heartbeat or heart strain	Chest pain, dyspnea, ankle swelling	Report urgently; ECG/echo; adjust therapy [5] [6] [7]
Immune‑related thyroid dysfunction	Hyperthyroidism causes fast heartbeat	Heat intolerance, sweating, weight loss	Thyroid tests; treat thyroid disorder [8] [5]
Anxiety/stimulants/electrolytes	Common non‑cancer triggers	Caffeine, decongestants, stress, low potassium	Reduce triggers; check electrolytes [2]
Arrhythmia (independent)	Electrical issue in heart rhythm	Persistent racing, dizziness, fainting	ECG/rhythm monitoring; cardiology consult [1]

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Bottom Line

Heart palpitations are not a hallmark symptom of endometrial cancer itself, but they can happen due to anemia, the effects of chemotherapy or immunotherapy on the heart, immune‑related thyroid problems, or common triggers like stress and caffeine. ^{[4] [5] [8] [2] [1]} Because some causes are benign and others potentially serious, a focused evaluation including blood tests for anemia and thyroid function and, when indicated, heart rhythm testing is usually appropriate. If palpitations come with chest pain, breathlessness, fainting, or persistent rapid heart rate during treatment, seek urgent medical care. ^{[3] [5] [6] [7]}