Hi, I have gone through your question. An echocardiogram cannot cause low pulse rate and dizziness. It is totally co-incidental. There is a possibility that you were little anxious about the Echocardiogram test per se and so worried about it. When one is emotionally disturbed, there can be profound effect on the heart rate/pulse. Secondly, a pulse rate of 45 can also be due to the medications you are already on. There is one group of cardiac/BP medicines called Beta-blockers which naturally keeps one s pulse rate low and I am not sure if you are on that medicines. Moreover, I also do not have an information about whether your pulse rate increased after your dizziness went away. regarding dizziness, when echo was taken you were lying down and the blood flow through heart to your brain was sufficient and when you suddenly stood up, there was pooling of blood in your legs and so blood to brain decreased and caused light-headedness. The less likely reason for dizziness is that it is secondary to sudden fall in pulse which is extremely unlikely in your case because there was no reason why your pulse should drop like that all of a sudden To put it in a nutshell, this entire scenario is most likely to be an effect of ageing and nothing to worry . Secondly,you need not worry because the pulse rate will be there on the echo report. Regards Dr. Jeffrey