Heart palpitations and blood pressure

A pounding, fluttering, or skipped-beat sensation can accompany stress, dehydration, fever, stimulants, or a change in blood pressure. It can also occur with anaemia, an overactive thyroid, low blood sugar, or an irregular rhythm such as atrial fibrillation. Heart failure may cause breathlessness and a fast or irregular heartbeat. These conditions are possibilities, not conclusions from a symptom or home reading.

Blood pressure is only a snapshot. The number can be affected by posture, pain, recent activity, caffeine, and the way the cuff is fitted. Record the reading, pulse, symptoms, and what you were doing at the time.

Sit quietly, breathe slowly, and avoid driving while you feel faint. Recheck blood pressure after resting, using an upper-arm cuff if available, with your arm supported. Drink water if you may be dehydrated and avoid extra caffeine, nicotine, and decongestants until the episode settles. Arrange a medical review if episodes recur, last longer, or interfere with sleep or activity; an examination, ECG, and blood tests may help identify the trigger.

Seek emergency help for palpitations with chest pain, severe breathlessness, fainting, new confusion, marked weakness, or a sustained very irregular heartbeat. Seek urgent advice for repeated episodes with dizziness or a concerning blood pressure reading. Do not wait for a home measurement if you feel seriously unwell.

Could my medicines, thyroid function, blood count, hydration, or blood sugar be contributing? Would an ECG or longer rhythm monitor be useful? How should I measure and record my blood pressure during an episode?