Are heart palpitations a symptom of liver cancer?

Heart palpitations are not considered a common or hallmark symptom of liver cancer itself. The typical symptoms of liver cancer include unintentional weight loss, loss of appetite, upper abdominal pain, nausea or vomiting, fatigue, abdominal swelling, jaundice (yellowing of the skin or eyes), pale stools, and sometimes fever or easy bruising/bleeding. ^[1] These symptom lists from major centers do not include palpitations as a usual presenting feature. ^{[2] [3]} In many people, liver cancer causes no symptoms until it is advanced, and even then, the symptoms are mostly abdominal or systemic (such as jaundice or weight loss), not cardiac. ^{[1] [4]}

When palpitations can happen in the context of liver cancer

While palpitations aren’t a classic symptom of liver cancer, there are several plausible, medically recognized reasons someone with liver cancer might experience them:

• Cancer treatments: Some targeted therapies used for advanced liver cancer, such as sorafenib, can cause fast or irregular heartbeats and may prolong the QT interval, which increases the risk of arrhythmias. ^{[5] [6]} Package information also warns to contact a clinician if you feel your heart racing or irregular. ^[7]
• Anemia: Cancer and cancer therapies can lead to anemia, which can trigger compensatory tachycardia and palpitations; patient information for sorafenib highlights becoming pale, dizzy, and fast heartbeat with low blood counts. ^[8]
• Electrolyte imbalances or dehydration: Vomiting, poor intake, or diarrhea can disturb potassium or magnesium levels, which can provoke palpitations and arrhythmias; QT‑prolonging drugs increase this risk. ^[6]
• Cardio-oncology considerations: Various anti-cancer drugs across oncology can affect heart rhythm or function (e.g., arrhythmias, myocarditis, cardiomyopathy), which may manifest as palpitations. ^{[9] [10]}
• Fever, pain, anxiety, or thyroid dysfunction: Systemic stress, infections, or metabolic changes common in serious illness can also lead to palpitations; while not specific to liver cancer, they frequently coexist during treatment. ^{[9] [10]}

Key differences: typical liver cancer symptoms vs palpitations

Liver cancer’s common symptoms cluster around abdominal discomfort, jaundice, swelling, fatigue, weight loss, and easy bleeding/bruising. ^{[1] [2]} Palpitations, in contrast, point clinicians toward cardiac rhythm issues, medication effects, anemia, or electrolyte problems rather than the tumor itself. ^{[9] [6]}

What to watch for and when to seek care

• Red flags needing urgent evaluation: chest pain, shortness of breath, fainting, sustained heart rate >120–130 bpm at rest, new irregular rhythm, or palpitations with dizziness or confusion. These may indicate a dangerous arrhythmia or other complications and warrant prompt medical attention. ^{[5] [8]}
• New palpitations soon after starting or increasing targeted therapy (e.g., sorafenib) should be reported promptly; clinicians may check an ECG and labs and consider dose adjustment. ^{[6] [7]}

How clinicians evaluate palpitations in someone with liver cancer

• History and exam: timing relative to medications; associated symptoms (chest pain, dyspnea, syncope), fever, fluid status. ^[9]
• Testing: ECG to assess rhythm/QT; blood tests for hemoglobin (anemia), electrolytes (potassium, magnesium), kidney function, and thyroid function; sometimes ambulatory monitoring if intermittent. ^{[9] [10]}
• Medication review: identification of QT‑prolonging or cardiotoxic agents and interactions; correction of risk factors. ^{[6] [10]}

Management approaches

Management depends on the cause; commonly used, evidence‑based steps include:

• Address reversible triggers: rehydrate, correct electrolytes (potassium, magnesium), manage pain, fever, or anxiety. ^[6]
• Treat anemia if present: evaluation for transfusion or iron therapy depending on severity and cause. ^[8]
• Adjust cancer therapy if implicated: clinicians may reduce dose, hold treatment, or switch agents, and involve cardio‑oncology for ongoing management. ^{[11] [9]}
• Cardiac‑directed therapy: if a specific arrhythmia is identified, options may include beta‑blockers or other antiarrhythmics, with careful coordination between oncology and cardiology to avoid drug interactions. ^{[12] [13]}
• Ongoing monitoring: follow‑up ECGs and labs if you remain on a QT‑prolonging or arrhythmogenic medication. ^[6]

Bottom line

• Palpitations are not a common or defining symptom of liver cancer itself. ^{[1] [2]}
• In people with liver cancer, palpitations more often reflect treatment side effects (e.g., sorafenib), anemia, electrolyte imbalances, or other medical issues rather than the tumor. ^{[6] [5]}
• Prompt evaluation is important especially if accompanied by chest pain, shortness of breath, fainting, or persistent rapid or irregular heartbeat because some causes can be serious but are manageable when identified early. ^{[8] [7]}