Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome on HCM!

I passed carefully through your medical history prescription and would explain that as you have experienced heart palpitations, the most probable cause of your hypotension seems to be a new episode of cardiac arrhythmia (most likely atrial fibrillation).

Coming to this point, as you have an obvious clinical symptomatology (dizziness, tiredness, etc.) due to marked hypotension the first immediate step to follow is to avoid taking your daily BP meds to prevent any further deterioration on BP values.

In addition, as you have a profound adverse implication of your hemodynamic status (symptomatic hypotension) in the settings of a probable cardiac arrhythmia the most prudent and wise measure to undertake is to ask medical assistance to the nearest ER service at your living area, because some preliminary medical tests should be done:

- resting ECG,
- thyroid hormones level,
- blood electrolytes level,
- cardiac ultrasound
- complete blood count
- kidney function tests
- also continuous blood pressure monitoring is necessary.

A prompt physical examination in addition to the above tests will be sufficient to determine the right cause of your complaints (atrial fibrillation with uncontrolled ventricular response, an underlying electrolyte or thyroid hormone imbalance, an impaired cardiac function, etc.).

Another point to consider and discuss with your doctor would be the possibility of starting oral anticoagulation therapy (in the absence of contraindications), because you have a CHA2-DS2-Vasc Score of 2 points, which means that you are at increased risk of ischemic stroke (in the settings of atrial fibrillation).

So, you should run to the ER and discuss the above mentioned issues with the service doctor.

Hope to have been helpful!

Feel free to ask me again whenever you need!

Kind regards,

Dr. Iliri

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