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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35072
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I went exercise class today- a lot of bending and light

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I went exercise class today- a lot of bending and light weight lifting, and up and down. I felt lightheaded when I would go from a squat to a stand position a few times. normal?
I have recently had a physical and my EKG came back normal.
I have been on sertraline, buspar, and clonazepam. I just started Cymbalta today and I am weaning off the sertraline slowing.
Here are three reading that I just took with in the last 15 minutes.
118/85 sitting down to 109/80 stand
139/95 squatting to 107/79 standing up
126/86 squatting to 98/65 standing up
Your thoughts please.

Your symptoms and blood pressure readings are suggestive of postural hypotension. It is a condition in which one experiences a upper (systolic) blood pressure drop of 20 mm Hg or more, or a lower (diastolic) blood pressure drop of 10 mm Hg or more, with or without an increase in heart or pulse rate.

In normal people the upper blood pressure falls by less than 10 and the lower one rises as a matter of fact by 2-3 reading. Since you have a significant fall, following would be advised;

1) Lifestyle modifications, such as avoiding sudden postural changes

2) Sitting on the edge of the bed for 5 minutes before standing,

3) Calf muscle exercises,

4) Drinking 2 liters of fluids per day,

5) Avoiding hot environments,

6) Raising the head of the bed to 15-20 degrees,

7) Elastic compression stockings

8) Medications, can be the culprit.

9) Medical treatment; fludrocortisone, midodrine, erythropoietin, and pyridostigmine. These are only needed if the symptoms are significant and persistent

Following investigations may be advised;

a) blood urea

b) serum creatinine

c) glucose tolerance test

d) HbA1c,

e) complete blood count (CBC),

f) electrocardiography (done already).

g) echocardiography,

h) magnetic resonance imaging of the head to rule out Multiple System Atrophy.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

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Customer: replied 5 years ago.

My pulse rate did change a bit as I sat/squatted to
standing as follows- 100 to 119, 77 to
105, 78 to 118

Would this make a difference?

Is this normal to just happen out of the blue?

This can come out of blue. Dehydration, inadequate fluid intake, more physical exertion may be responsible. Pulse rate variation does not point to any specific diagnosis but can be due to dehydration. Before and during your dance classes, you should drink Gatorade, pedialyte or coconut water. These would likely to prevent the symptoms.
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