[36F] Experiencing dizziness, palpitations, and shortness of breath

Patient Description

A 36-year-old female reports experiencing dizziness upon standing, with episodes of lightheadedness lasting between 10 and 30 seconds, occurring multiple times a day for around 10 years. The dizziness is sometimes severe enough that she feels she could fall and has to hold onto something. Associated with the dizziness, she experiences hot and cold flashes, shortness of breath, and a racing heart, particularly when performing physical activities like chores. She also notes that her symptoms, including palpitations that can feel like racing or fluttering, worsen in the summer heat and with exertion. There is a family history of heart disease on her father's side. She does not report any chest pain, discomfort, or swelling in her legs or ankles. She has not experienced fainting or loss of consciousness during these episodes.

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Arora's Assessment

What might be happening

Based on the information you've provided, the symptoms you're experiencing could be due to:

  • Orthostatic Hypotension: This condition occurs when your blood pressure falls significantly as you stand up from sitting or lying down. This can cause dizziness, lightheadedness, and even fainting. It's more common in older adults, but can happen at any age.

    • Testing typically involves blood pressure measurements in different positions. Treatment often involves lifestyle changes and sometimes medication.
  • Postural Orthostatic Tachycardia Syndrome (POTS): This is a condition that affects circulation (blood flow). It involves the autonomic nervous system and sympathetic nervous system. Symptoms can include lightheadedness, fainting, and rapid heartbeat.

    • Diagnosis is typically made through a tilt table test or a standing test. Treatment usually involves a combination of lifestyle changes and medications.
  • Anxiety Disorders: Anxiety can cause a variety of physical symptoms, including dizziness, rapid heart rate, and shortness of breath. However, these symptoms usually occur in the context of feelings of intense fear or worry.

    • Treatment typically involves a combination of therapy, lifestyle changes, and medication.

What you can do

While waiting for your appointment with your healthcare provider, here are some things you can do:

  1. Stand up slowly: When you get up from sitting or lying down, do it slowly. Pause for a few seconds before standing up completely. This allows your body time to adjust and can help prevent dizziness.
  2. Stay hydrated: Dehydration can worsen symptoms of orthostatic hypotension and POTS. Make sure you're drinking enough fluids throughout the day.
  3. Limit alcohol and caffeine: These can dehydrate you and affect your blood pressure and heart rate.
  4. Exercise regularly: Regular physical activity can help improve your symptoms. However, make sure to start slow and gradually increase your activity level.

What you should look out for

Please seek immediate medical attention if you:

  • Faint or lose consciousness
  • Have chest pain or pressure
  • Have a severe headache
  • Have difficulty breathing
  • Have a rapid or irregular heartbeat

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with your healthcare provider for accurate information.

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10 mo ago

People Also Ask


What is orthostatic hypotension and how is it diagnosed?

Orthostatic hypotension is a condition where blood pressure drops significantly when standing up from sitting or lying down, causing dizziness or lightheadedness. It is diagnosed by measuring blood pressure in different positions, such as lying down and standing.


What are the symptoms and treatment options for Postural Orthostatic Tachycardia Syndrome (POTS)?

POTS is a condition affecting blood circulation, characterized by symptoms like lightheadedness, fainting, and a rapid heartbeat upon standing. It is diagnosed through tests like a tilt table test. Treatment often includes lifestyle changes and medications to manage symptoms.


Can anxiety cause physical symptoms like dizziness and a racing heart?

Yes, anxiety can cause physical symptoms such as dizziness, a rapid heart rate, and shortness of breath, often in the context of intense fear or worry. These symptoms can be managed with therapy, lifestyle changes, and sometimes medication.


What lifestyle changes can help manage symptoms of dizziness and palpitations?

To manage symptoms of dizziness and palpitations, it is recommended to stand up slowly, stay hydrated, limit alcohol and caffeine intake, and engage in regular physical activity, starting slowly and gradually increasing intensity.


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