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What Causes Dizziness And Black Outs While Standing For A While?
Question: My husband keeps getting dizzy and his vision blacks out when he stands up. This does not happen all the time, but enough of the time to be concerning.
Also, several times a month he gets really dizzy simply sitting on the couch. He almost passed out a few minutes ago. Afterwards he feels very nauseated. Also, whenever he leans over he feels a lot of pressure in his head and feels nauseated. He also sometimes gets a headache after a bout of dizziness.
He is only 31 and has been having these symptoms since high school. We know these symptoms are not related to dehydration because he drinks more than the recommendation for water.
Also, several times a month he gets really dizzy simply sitting on the couch. He almost passed out a few minutes ago. Afterwards he feels very nauseated. Also, whenever he leans over he feels a lot of pressure in his head and feels nauseated. He also sometimes gets a headache after a bout of dizziness.
He is only 31 and has been having these symptoms since high school. We know these symptoms are not related to dehydration because he drinks more than the recommendation for water.
Brief Answer:
This is suggestive of orthostatic hypotension!
Detailed Answer:
Hi and thank you so much for this query.
I am so sorry to hear about what your husband has been experiencing. From the symptoms you have reported he probably witnesses a drop in blood pressure each time he stands up. There is a nervous pathway that normally tends to adjust and maintain the blood pressure when we rise suddenly so that we do not develop these symptoms and should this not happen fast or normally, these symptoms are almost inevitable.
To investigate this, he would need to be evaluated both in the sitting and upright positions to see how much difference exist in his cardiovascular parameters like blood pressure and pulse rate. This can be completed by doing a tilt table test to further conclude on the possibility of orthostatic hypotension or not. I will suggest he gets a cardiologist appointment for evaluation and management.
For now, let him avoid positions and postures that provoke these symptoms as they can lead to a fall with all its possible consequences like fractures, wounds, etc. He should also avoid dangerous landscapes and unsafe milieu like high altitudes.
In all, probably caused by a delay in adjusting blood pressure in upright position rapidly after rising. Investigations would help to establish the cause and guide in proposing a management plan. For now, taking precautions to avoid provoking symptoms and related consequences is the best way forward.
I hope this helps. I wish him well. Thank you so much for using our services and do feel free to ask for more information and clarifications if need be.
This is suggestive of orthostatic hypotension!
Detailed Answer:
Hi and thank you so much for this query.
I am so sorry to hear about what your husband has been experiencing. From the symptoms you have reported he probably witnesses a drop in blood pressure each time he stands up. There is a nervous pathway that normally tends to adjust and maintain the blood pressure when we rise suddenly so that we do not develop these symptoms and should this not happen fast or normally, these symptoms are almost inevitable.
To investigate this, he would need to be evaluated both in the sitting and upright positions to see how much difference exist in his cardiovascular parameters like blood pressure and pulse rate. This can be completed by doing a tilt table test to further conclude on the possibility of orthostatic hypotension or not. I will suggest he gets a cardiologist appointment for evaluation and management.
For now, let him avoid positions and postures that provoke these symptoms as they can lead to a fall with all its possible consequences like fractures, wounds, etc. He should also avoid dangerous landscapes and unsafe milieu like high altitudes.
In all, probably caused by a delay in adjusting blood pressure in upright position rapidly after rising. Investigations would help to establish the cause and guide in proposing a management plan. For now, taking precautions to avoid provoking symptoms and related consequences is the best way forward.
I hope this helps. I wish him well. Thank you so much for using our services and do feel free to ask for more information and clarifications if need be.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
What about this part "Also, several times a month he gets really dizzy simply sitting on the couch. He almost passed out a few minutes ago. Afterwards he feels very nauseated. Also, whenever he leans over he feels a lot of pressure in his head and feels nauseated. He also sometimes gets a headache after a bout of dizziness." You did not touch on this in your response, only the dizzy from sitting to standing was mentioned. This that I quoted is the most concerning to me.
Brief Answer:
Sae spectrum of conditions, lipothymia!
Detailed Answer:
Hi and thank you so much for this follow up precision.
It is true that I really didn't talk about this specifically. All these symptoms of almost passing out alongside dizziness, nausea, etc are collectively called lipothymia.
Lipothymia results from a poor blood supply to the brain. What exactly causes this rotates around the blood system and its control. For this, the heart, blood vessels and the nervous pathways that seek to maintain the blood pressure irrespective of our position needs to be evaluated. If he gets dizzy after having been sitting on the couch for long, then it would be less likely to be entirely explained by the rapid pressure changes like I mentioned earlier. In this case, we would have to look more at the heart itself and how regular are the beats in addition to the already mentioned tests above.
Getting a baseline EKG and also a holter monitoring to be able to look at what the heart parameters are over time and correlate them with his symptoms would be very helpful. This could be an arrhythmia, especially happening after a while in the same position. I will not want to suggest possible vascular blocks because of his age and the absence of risk factors for vessel blocks.
In all, the nervous control and heart functions that maintain a steady supply of blood to the brain irrespective of our positions needs to be evaluated. Tilt test, parameters in upright, sitting and dorsal decubitus positions, baseline EKG and a holter monitoring would shed more light and guide further investigations if not conclusive enough to establish a cause and suggest treatment.
I hope this helps. Feel free to ask for more information and clarifications if need be.
Sae spectrum of conditions, lipothymia!
Detailed Answer:
Hi and thank you so much for this follow up precision.
It is true that I really didn't talk about this specifically. All these symptoms of almost passing out alongside dizziness, nausea, etc are collectively called lipothymia.
Lipothymia results from a poor blood supply to the brain. What exactly causes this rotates around the blood system and its control. For this, the heart, blood vessels and the nervous pathways that seek to maintain the blood pressure irrespective of our position needs to be evaluated. If he gets dizzy after having been sitting on the couch for long, then it would be less likely to be entirely explained by the rapid pressure changes like I mentioned earlier. In this case, we would have to look more at the heart itself and how regular are the beats in addition to the already mentioned tests above.
Getting a baseline EKG and also a holter monitoring to be able to look at what the heart parameters are over time and correlate them with his symptoms would be very helpful. This could be an arrhythmia, especially happening after a while in the same position. I will not want to suggest possible vascular blocks because of his age and the absence of risk factors for vessel blocks.
In all, the nervous control and heart functions that maintain a steady supply of blood to the brain irrespective of our positions needs to be evaluated. Tilt test, parameters in upright, sitting and dorsal decubitus positions, baseline EKG and a holter monitoring would shed more light and guide further investigations if not conclusive enough to establish a cause and suggest treatment.
I hope this helps. Feel free to ask for more information and clarifications if need be.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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