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Suggest Treatment For Dizziness In An Elderly Person With Diabetes
Question: Male 79, low pulse 58/; lightheadedness; 1 past instance of heart Fib(?); been on pills for diabetes, +1 for blood thinner, 1 hart pill; take sugar or liquid? Diabetes monitor reads 7.4
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Regarding your heart rate, it is not too low. As long as it is rhythmic heart rate, we can not conclude about atrial fibriallation or any other types of cardiac arrhythmia.
What about your blood pressure values? Have you measured it?
Is lightheadedness triggered by standing up or head movements? If your symptoms are triggered by standing up, they could indicate possible orthostatic hypotension (which is commonly associated to diabetes). If your symptoms are triggered by head movements (even when lying down), this could indicate possible chronic degenerations of the cervical spine or an inner ear disorder.
Considering your symptoms and your past medical history (presence of cardio-vascular risk factors such as diabetes), I would recommend going to the ER for a careful physical exam and some tests:
- a resting ECG
- blood electrolytes for possible imbalance
- complete blood count for anemia
- Doppler ultrasound of the cervical vessels to exclude possible atherosclerotic narrowing
- a cervical spine X ray study.
Meanwhile, I recommend you to closely monitor your blood pressure values in sitting and then standing up position. Taking plenty of fluids will help to remain well hydrated.
If suspicions of orthostatic intolerance are raised during physical exam, a Head Up Tilt test would be needed to investigate for this issue.
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Regarding your heart rate, it is not too low. As long as it is rhythmic heart rate, we can not conclude about atrial fibriallation or any other types of cardiac arrhythmia.
What about your blood pressure values? Have you measured it?
Is lightheadedness triggered by standing up or head movements? If your symptoms are triggered by standing up, they could indicate possible orthostatic hypotension (which is commonly associated to diabetes). If your symptoms are triggered by head movements (even when lying down), this could indicate possible chronic degenerations of the cervical spine or an inner ear disorder.
Considering your symptoms and your past medical history (presence of cardio-vascular risk factors such as diabetes), I would recommend going to the ER for a careful physical exam and some tests:
- a resting ECG
- blood electrolytes for possible imbalance
- complete blood count for anemia
- Doppler ultrasound of the cervical vessels to exclude possible atherosclerotic narrowing
- a cervical spine X ray study.
Meanwhile, I recommend you to closely monitor your blood pressure values in sitting and then standing up position. Taking plenty of fluids will help to remain well hydrated.
If suspicions of orthostatic intolerance are raised during physical exam, a Head Up Tilt test would be needed to investigate for this issue.
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I just wanted to know short term immediate treatment for lightheadedness: drink water, eat sugary something, take aspirin. Dont have access to other test to take. Alsodont know what you mean "blood pressure values" - how measure, you mean take pulse? Only good info is that heart rate was not too low. Thnx for that.
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello again!
I would explain that blood pressure values can be evaluated with a blood pressure machine.
If you do not have such machine, you can not measure your blood pressure values.
But, you can make a trial: take a coffee. If your symptoms are improved by coffee, it may be indicative of low blood pressure as a possible cause of lightheadedness.
Another argument in favor of low blood pressure would be the fact that your symptoms worsen when standing up from sitting position. Does this happen to you?
Regarding sugar, I would not recommend taking further sugar as your blood sugar values are not low.
Regarding aspirin, I would recommend taking only a daily dose of 80-100mg of aspirin (as a anti-platelet agent). It will not improve lightheadedness, but can help prevent possible strokes.
I would recommend taking plenty of fluids (water) to remain well hydrated and avoid straining physical activity. Having some rest will be helpful.
Hope you will find this answer helpful!
Wishing all the best,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello again!
I would explain that blood pressure values can be evaluated with a blood pressure machine.
If you do not have such machine, you can not measure your blood pressure values.
But, you can make a trial: take a coffee. If your symptoms are improved by coffee, it may be indicative of low blood pressure as a possible cause of lightheadedness.
Another argument in favor of low blood pressure would be the fact that your symptoms worsen when standing up from sitting position. Does this happen to you?
Regarding sugar, I would not recommend taking further sugar as your blood sugar values are not low.
Regarding aspirin, I would recommend taking only a daily dose of 80-100mg of aspirin (as a anti-platelet agent). It will not improve lightheadedness, but can help prevent possible strokes.
I would recommend taking plenty of fluids (water) to remain well hydrated and avoid straining physical activity. Having some rest will be helpful.
Hope you will find this answer helpful!
Wishing all the best,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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