Orthostatic hypotension with tachycardia

When blood pools in the legs after standing, the body may increase heart rate to help maintain circulation to the brain. If the response is not enough, you may feel light-headed, weak, shaky, short of breath, or aware of pounding heartbeats. Dehydration, recent illness, heat, low blood volume, anaemia, medicines, and some problems with automatic nervous control can contribute. A fast pulse has many possible explanations and needs context rather than a label based on one reading.

Stop and sit or lie down when symptoms begin. Stand gradually, avoid overheating, and keep fluids steady if your clinician permits. Do not repeatedly provoke symptoms to test your pulse. Record your position, pulse if measured safely, symptoms, recent food and fluids, illness, and medicines. A GP can check whether the pulse response matches the blood-pressure change and decide whether further evaluation is needed.

Seek urgent care for a fast heartbeat with chest pain, severe breathlessness, fainting, marked weakness, confusion, or a persistent irregular rhythm. Arrange a prompt appointment for repeated position-related episodes, a new resting fast pulse, or symptoms after starting or changing treatment. Do not assume every rapid heartbeat is caused by orthostatic hypotension.

Ask how to measure pulse and blood pressure safely, whether dehydration or medicines could be involved, and whether blood or heart tests are appropriate. Ask which symptoms should prompt emergency help.