<s>[INST] Well i am on the phone with my cousin right now. she just drove herself to the doctors this morning because she said her heart was pounding very fast, and she had a tingling feeling down her arm and saw pulsating vein in her left palm. dr. said her pressure was 180 over 104 [/INST] DEAR USER,THANKS FOR CONSULTING WITH HCMI UNDERSTAND YOUR CONCERNYOUR COUSIN BP IS VERY HIGH AND SUCH HIGH BP CAN CAUSE  SYMPTOMS OF PALPITATION AND POUNDING VESSELSI ADVISE YOU TO URGENTLY CONSULT THE ER AND GET HER BLOOD PRESSURE CONTROLLED AFTER WHICH THE CONSULTING PHYSICIAN CAN EVALUATE HER TO FIND THE CAUSE OF HER DISEASEHOPE I ANSWERED YOUR QUERY. YOU CAN MESSAGE ME FOR ANY FURTHER CONCERNS </s>