What Causes Lightheadedness And BP Falls While Sitting Or Standing?

Posted on Thu, 19 Mar 2015

Question: Hi I am experiencing light headedness a fair bit through out most of the day, and am off balance by a bit when walking.....I have gone through heart tests both stress tests and a holter monitor.....and they are good. I checked these as I had an reentrentant tachycardia ablated 4 months ago, am on a minimal dose of Atenolol 12.5 mgs blood pressure 105/82 pulse 69. and still I am fatigued and light headed. My blood pressure according to my doc goes down slightly from sitting to standing, and believes the is the problem. I have been put on iron pills for low iron....I live at sea level yet my ears pop occasionally and I have had a sinus cold (but not any longer).

Answered by Dr. Sudhir Kumar (9 minutes later)

Brief Answer:
Your doctor seems to be correct.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted your symptoms, and your doctor's thinking seems to be correct. These symptoms are common with postural hypotension, where the BP falls on standing or getting up from lying down position.

Regarding ear infection, the symptoms are dizziness, which is made worse on turning the head or neck in one direction. So, your symptoms are not typical, but can occur with ear infection. This usually settles down on own in a few days to weeks.

In any case, there is no need to worry, as normal stress test and Holter have ruled out any serious cardiac problem.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Sudhir Kumar (53 minutes later)

OK.....so is there any other line of investigation for the sensation of being off balance, and fatigued. I am normal y a healthy or do I just live with it?? , active 68 year old...am not overweight and this feeling is not normal. Are there strategies I could use to deal better with it.

Answered by Dr. Sudhir Kumar (3 minutes later)

Brief Answer:
An ENT evaluation would be useful.

Detailed Answer:
Thank you for getting back.

ENT evaluation including audiometry and vestibular function tests would be useful in assessing the role played by ear problem in causing your symptoms.

Adjustment of BP medications (reduction of dose or change in medications) under supervision of your doctor may eliminate the postural fall in blood pressure, thereby, minimising your symptoms.

Vestibular adaptation exercises under the guidance of physiotherapist are useful in ensuring faster recovery.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Sudhir Kumar (1 hour later)

Thank you! Ps I have cut the dosage of beta blocker down to 12.5 from 25 mgs which I was told was half the minimum dose to start with.

Answered by Dr. Sudhir Kumar (5 hours later)

Brief Answer:
Agree with the reduction of dose.

Detailed Answer:
Thank you for getting back.

I agree with the dose reception of beta blocker. It would help you get better.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

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Above answer was peer-reviewed by : Dr. Shanthi.E