Frequent Dizzy Spells
Q: Recently I've been experiencing pretty frequent dizzy spells, sometimes
as often as once a day. They hit just after I stand up from a chair, and usually
it's after a full day of running errands and feeling fine. I don't understand:
I eat well and exercise regularly. What could be wrong?
Dr. Donnica: Dizzy spells are fairly common and have many different causes,
but they always require medical evaluation. When dizziness is specifically associated
with getting up from a seated or supine (lying down) position, they are probably
related to orthostatic hypotension. This is defined as a drop in systolic blood
pressure (the top number) of more than 20 "points" (mm Mercury) when
you go from a supine position to standing. Making the diagnosis is easy and painless:
Your doctor will take your blood pressure in standing, sitting and lying down
positions in both arms and compare them. If there are significant differences,
you will need a complete physical exam and several other tests to determine the
specific cause.
Orthostatic hypotension can be caused by numerous factors ranging from side
effects of certain medications (including antihypertensives, diuretics, nitrates,
hydralazine, barbiturates, opiates, tricyclic antidepressants, and phenothiazines)
to various cardiac or nervous system problems, as well as systemic diseases
such as diabetes, stroke and alcoholism. This condition is also much more common
in the elderly, and symptoms are often worse after eating a large meal.
Created: 1/24/2004 - Donnica Moore, M.D.
