Confusion/difficulty concentrating

What is confusion?

Confusion is the feeling of disorientation or being unsure about one’s surroundings, memory, or identity. It also affects one’s attention and ability to think clearly. It happens when there is widespread disruption to brain activity.

Confusion is often wrongly associated with experiencing small missteps, errors or inaccuracies. However, confusion, from a medical point of view, means something different. It is more related to the sensation of impaired thinking and awareness, which can significantly affect your day-to-day life.

Can the heart be involved?

While often associated with neurological conditions, confusion can also be caused by reduced blood flow to the brain, including from specific heart problems.

Causes

Some heart conditions can reduce blood flow to the brain due to the heart’s insufficient pumping of blood, which can cause confusion. These can include arrhythmias (such as atrial fibrillation), heart disease, heart failure, heart defects or other structural problems you may be born with, or a heart attack.

This can lead to symptoms such as:

Mental fog
Difficulty focusing
Slower thinking
Sudden disorientation

Common cardiovascular causes of brain and cognitive symptoms include:

Heart conditions	Impact on the brain, which may lead to symptoms
Heart failure	If your heart isn’t able to pump enough blood, your brain might not get the blood and oxygen it needs.
Bradycardia or heart block	Slower heart rates may not send enough blood and oxygen to your brain.
Postural hypotension or autonomic dysfunction	Sudden drops in blood pressure.
Arrhythmias	If your heart beats in an irregular or unsteady way, it might briefly reduce the amount of blood and oxygen reaching your brain.

Explore our interactive symptom finder to discover whether other symptoms you may be experiencing are a sign of a heart condition.

When is it an emergency?

Confusion can be caused by various factors, often less serious ones, such as dehydration, migraines, low blood sugar, or certain medications.

However, experiencing confusion can also be a sign of more concerning issues, such as a stroke or a heart attack. If you experience chest pain, shortness of breath, nausea, dizziness, unexplained anxiety, fatigue, palpitations, or cold sweats alongside confusion, call 999 or go to the hospital immediately.

When to suspect it is caused by the heart

Confusion may be caused by heart problems if:

It begins suddenly, without any prior memory or thinking problems.
It happens after standing up, physical activity, or when you feel short of breath.
It comes with a fast or irregular heartbeat, feeling dizzy, or fainting.
Brain scans show no problems, but the confusion continues.

In older adults, these signs can sometimes be wrongly thought to be normal ageing or memory issues, but they might actually mean your heart isn’t pumping blood steadily.

If you notice any of these signs, it’s important to check your heart to help protect your heart’s health.

Tests and investigations

To assess if reduced blood flow to the brain is causing confusion, the following heart and circulation tests may be considered:

Heart test	Suspected cardiovascular cause
24-hour ambulatory blood pressure monitoring	To detect episodes of hypotension (low blood pressure)
ECG	To identify bradycardia, pauses, or conduction abnormalities
Echocardiogram	To assess ventricular function and stroke volume
Tilt table testing	To check if standing up or automatic body processes are causing problems
Holter monitor or loop recorder	To detect intermittent arrhythmias
Cardiac MRI	For structural assessment, if heart failure is suspected
Blood tests	To assess for heart failure

Looking after your heart health

Confusion is often linked to problems in the brain, but sometimes it can come from heart or circulation issues, especially when brain scans look normal but the confusion does not go away.

For some patients, checking the heart carefully can reveal treatable blood flow problems that affect how the brain works

Book your consultation

Tests to further investigate concerns

Electrocardiogram (ECG)

Electrocardiogram (ECG or EKG)

An electrocardiogram is a test that measures and records your heart’s electrical activity and rhythm, including the strength and speed of your heartbeat.

Chest X-ray

A chest X-ray is a scan that can provide images of the heart, lungs, blood vessels, and much more. It helps show us the size and shape of the heart and detect any abnormalities.

Book your consultation  with Dr Ravi Assomull today

Looking after your heart is the most important thing you can do to improve your longevity and quality of life in the long term.

We’re here for you during your journey to better heart health. We provide tests and management strategies to help identify what might be wrong and where you can improve your lifestyle to reach prime heart health.

Book an appointment today to speak to our expert Integrative Cardiologist, Dr Ravi Assomull, about your heart concerns.

You can email us at: enquiries@cardiologist.london

Or call us at: 020 3576 2885

Frequently asked questions

Answers from the team at Cardiologist London. For personalised advice, book a consultation or call 020 3576 2885.

Can heart problems cause confusion or poor concentration?

They can. If the heart pumps less effectively - as in heart failure or some rhythm problems - blood flow to the brain can fall, causing brain fog, poor concentration or episodes of confusion, particularly in older adults.

When should confusion be treated as an emergency?

Sudden confusion is a medical emergency - call 999, especially with face drooping, arm weakness or slurred speech (possible stroke), or with chest pain, breathlessness or an irregular pulse.

What heart tests are useful for unexplained brain fog?

An ECG and ambulatory monitor look for rhythm problems such as atrial fibrillation (a common, treatable cause), blood tests exclude anaemia and thyroid disease, an echocardiogram assesses pumping function, and a 24-hour blood pressure monitor picks up pressure swings.