I Am Looking For Direction For My 78 Yo Dad

Posted on Thu, 13 Sep 2018

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 13 Sep 2018 Answered on

Last reviewed on

Question : I am looking for direction for my 78 yo dad who over last 6 months has had 8 episodes of low blood pressure 60/40, high heart rate 180, dizziness and almost passes out. He is diabetic but does not feel like a low blood sugar event.
I witnessed this for the first time this weekend and it was really scary. His doctor thinks its a low blood pressure problem and wants him to cut his dose. I am not convinced

Answered by Dr. Ilir Sharka (32 minutes later)

Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on Ask a Doctor service!

I passed carefully through your question and would explain that these episodes could also be related to a possible cardiac arrhythmia, considering the high heart rate.

For this reason, I would recommend performing a cardiac ultrasound and an ambulatory 24-48 hours ECG monitoring in order to examine his heart rhythm trends for a prolonged time and investigate for possible cardiac arrhythmia.

I would also recommend to monitor and compare his blood pressure values and heart rate values in sitting position and then in standing up position.

A drop in blood pressure values or increase in heart rate from sitting to standing up position, may indicate possible orthostatic intolerance.

In such case, a Head Up Tilt test may be needed.

You should discuss with his doctor on the above tests.

Hope to have been helpful!

Wishing good health,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar