What Causes Dizziness, Weak Legs And Balance Issues While Treating A Heart Failure?

Brief Answer:
Pharmacodynamics of med interactions is not entirely understood

Detailed Answer:
Good evening sir. Many thanks for your question and I'm impressed with your powers of logical thinking. It would've been so much easier getting through that pharmacology class in med school if only the dynamics of drug to drug interactions were that predictable and mathematically related! But your logical reasoning is spot on. I agree that the most likely culprit to your "dizziness" which I'm assuming you mean is "LIGHTHEADEDNESS" and/or imbalance as opposed to vertigo or sense of spinning or falling are the large number of medications (all of which can lower blood pressure) and the interactions between them. I can tell you that the mechanism to the vast majority of dizziness, feelings of near syncope (nearly passing out), leg weakness while standing, reduced ability to ambulate due to vertigo or lightheadedness is medication induced secondary effects.

The easiest way to prove this conjecture is to simply begin retiring medications one at a time leaving behind only the ABSOLUTE NECESSARY ones and measuring how your ORTHOSTATIC PRESSURES change which means that either you or someone will need to take and document pressures at least once daily in different positions and over time as you go taking down the medications to find out at which point you notice that you no longer feel the dizziness factor.

You should discuss things with the doctor(s) prescribing these medications and see how things can be consolidated because in my opinion you could probably do just as well with a couple less of these medications. I typically will also a set of blood pressures which we refer to as ORTHOSTATIC PRESSURES and keep track of these pressures at least several times per week while also weaning down medications to see how things change. Your doctor can do these type of pressure readings but in your case I would probably get what is called a modified AMINOFF protocol which is slightly different from how most internists do orthostatics.

Good luck at tomorrow's appointment. I hope your doctor can find a way of streamlining your medication list for you and/or making other suggestions to you that would get at boosting up your system's pressures if you are found to be orthostatic such as fluid hydration, compression stockings (thigh highs preferable), or increased salt intake (which most internists would cringe at hearing...but it really does correct orthostatic hypotension very nicely).

Cheers!

I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload more specific information regarding lab tests and diagnostic studies if done and I'll be happy to look at them in the context of your question.

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This consult request has taken a total of 52 minutes of time to read, research, and respond.

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