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Acute Dizziness and Lightheadedness

Blood Circulation Related Dizziness – Orthostatic Hypotension – Cardiac Arrhythmia – Dizziness in Panic Attacks

Blood Circulation Related Dizziness
Blood circulation compromise can decrease the blood supply to the brain causing sensation of lightheadedness, blurred vision, and altered awareness. It may lead to fainting (syncope) if taken to extreme.

Imagine the body as a building with multiple floors and our blood circulating system as a plumbing system in this building. The brain is on the top floor. The top floor can get low pressure in the pipes for three major reasons: pump failure (heart), narrow pipes (blocked blood vessels), or heavy consumption of water (blood) in the lower floors (heavy meal and/or alcohol). Insufficient blood volume reaching the brain causes lightheadedness and may even lead to fainting.

Blood vessels are not rigid (unlike cooper pipes). The diameter is changing depending on the pressure and it has to be constantly controlled in order to keep up with the circulating blood volume. We don’t faint all the time when we stand up because blood pressure, heart rate, and blood vessel diameter are constantly monitored and are adjusted depending on the body position.

Orthostatic Hypotension
This is a lightheadednes upon sitting up or standing up. Common causes are low circulating blood volume caused by dehydration, high temperature, alcohol, sweating, large meals, medications or a combination of them.

Under normal circumstances, standing up generates a chain of reflexes in the body leading to increased heart rate and narrowing of the blood vessels in the lower body. These reflexes become imperfect with aging, in diabetes, and in Parkinson’s disease. Low heart rate is a common cause of orthostatic lightheadedness as well.

Lightheadedness is only rarely caused by narrow blood vessels supplying the brain. Lack of brain circulation due to a blocked blood vessel will more likely cause a stroke. The best treatment is a detection and correction of the underlying cause, whenever possible.

Cardiac Arrhythmia
Lightheadedness due to circulation failure caused by inefficient heart pumping is a potential life threatening condition. The heart can efficiently pump the blood within a certain range of beat frequency. Both too fast and too slow are bad.
Dizziness in Panic Attacks
Panic attacks are recurrent episodes of intense anxiety associated with palpitations, numbness (often around the mouth or even the whole body), fear of death, shallow rapid breathing with a sense of air hunger, palpitations, dizziness or lightheadedness, shivering, chest discomfort, nausea or fear of “going crazy”.

Panic attacks last no longer than a few minutes, but they are frightening to the patients. Outside observers see no more than severe anxiety and agitation.

Panic attacks severely affect the quality of life. People with anxiety disorder change their life styles to avoid situations associated with these attacks in the past.

Panic attacks are often associated with lightheadedness for a good reason. Hyperventilation is a common associate of a panic attack. Inappropriately rapid ventilation leads to low concentration of carbon dioxide in the blood, which leads to narrowing of the blood vessels throughout the brain. Hyperventilation leads to lightheadedness, numbness in the face or the whole body, or even fainting.
Dizziness in panic attack is perceived as lightheadedness, shakiness or impending faint.

Dizziness resolves if panic attack disorder is successfully treated.