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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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My son is 22 and says he is having periodic light

Customer Question

My son is 22 and says he is having periodic light headedness, especially when he lifts weights but ironically, not when he plays basketball which is cardiovascularly more strenuous. He also is having some periodic numbness in his right foot. What might be going on here?
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hello, welcome to JA. Feeling light headed when straining to lift weights can be a normal response, called the valsalva, if you hold your breath, and increase your intrathoracic pressures, you stimulate your vagus nerve, which slows your heart rate, and causes your cardiac output to drop, giving you that sensation. The fact that he does well in basketball helps to eliminate the other condition (IHSS-idiopathic hypertrophic subaortic stenosis) which can cause lightheadedness with exercise as an outflow track obstruction from the heart. But he should see his doctor to get some testing if not already done. Checking his blood pressure in several positions, checking his valsalva response to see that there is no major overshoot response, that can happen in conditions like mitral valve prolapse, listening to his heart sounds, etc. If he plays basketball, he may have had all of that done. Periodic numbness in the right foot also sounds like a vascular symptom, if he drops his pulse pressure to the leg. He needs his dorsal pedis pulse at the top of his foot checked during an episode to see if it is down. Again, you could consider this related to an outflow track obstruction. Please get back to me if you have question and I will reply. Dr Frank

Customer: replied 1 year ago.
What are all the specific things he should ask a doctor to check for when he gets an appointment?
Expert:  Dr. Frank replied 1 year ago.

He needs the general cardiovascular workup. So checking his blood pressure standing and sitting, checking his heart rate to see if he is orthostatic. As I mentioned above. You are looking for some cardiac problem that can cause lightheadedness in an exercise or valsalva situation, so listening to the heart looking for a murmur or rub, so some valvular click. An EKG for changes consistent with ventricular enlargement (hypertrophy), maybe he needs an echocardiogram. It all depends what is found on physical examination. I hope that helps. Please get back to me if you have further questions and I will respond, or if satisfied, please remember to rate my service by clicking on the rating stars as that is how I am compensated for this work thanks Dr frank