Dizziness and blackouts

Dizziness means different things to different people. Some describe the room spinning. Some feel light-headed, as though they might faint. Some feel unsteady on their feet without any spinning at all. These have quite different causes, and carefully evaluating what is occuring is the first step in improving the symptom.  

​One cause of dizziness is easily measured and frequently missed. Blood pressure normally adjusts within seconds of standing up. With age, and with many common medications, that adjustment slows, so blood pressure drops when you stand and the brain briefly receives less blood supply and oxygen than it needs. The result is light-headedness on standing, sometimes after meals, sometimes only in the mornings, and sometimes a fall or a faint with no warning at all. This is known as  orthostatic hypotension; it is common, and it is treatable but needs to be properly assessed and measured. 

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Other causes of dizziness include problems with the inner ear, irregularities of heart rhythm, anaemia, dehydration, and the effect of medications taken together. More than one is often at work.

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A loss of consciousness deserves very specific attention and however brief, needs a proper explanation, because some causes are serious and treatable. ​

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If you have blacked out, had chest pain or palpitations beforehand, or lost consciousness while sitting or lying down, please do seek medical attention now rather than waiting for an appointment.​

How Professor Henderson can help ​

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• Establishing what kind of dizziness you have.

• Measuring blood pressure lying and standing, which is the single most useful test and the one most often not done.

• A full review of medications, since these are among the commonest causes and among the most correctable.

• Investigating heart rhythm and other cardiac contributors, and referring on where specialist cardiac assessment is needed.

• Treating orthostatic hypotension, which involves more than medication: fluid and salt intake, how you stand, compression, and adjusting the drugs that are causing it.

• Advice on driving, which the law treats differently depending on the cause.