I had two falls followed by dizziness and heavy sweating. What could be the reason?

Question

Hi doctor,

I am a 41 year old female with regular periods. I am 5'4" and weighs approximately 165 pounds. I have fainted this morning and almost exactly a month ago. The first time was in the middle of the night. When I woke up to use the bathroom, and while I was in the toilet, I broke out in a clammy sweat. I made it to the kitchen and started getting real lightheaded and almost dizzy. I remember a little bit of spotty vision and ear ringing. I know I heard and felt hit the floor, but I do not remember going down. It seemed almost instant that I woke up still sweaty. Besides being in pain from the fall, I felt better. This morning, I woke up and started my routine just fine. After about 15 minutes of being awake and moving around, the same thing happened. I began sweating and getting dizzy. Fearing what happened last time, I consciously slide myself down to sit on the floor, but I still fell forward hitting my head on the table in front of me. Again, I was sweaty but felt better. Approximately, three years ago, my PCP diagnosed MS with my MRI, but my neurologist denied that.

Answer 1

Hi,

Welcome to icliniq.com. It looks like a cardiac issue. It is most probably occurring due to fall in blood pressure and which is mostly due to either a vagal reflex or low heart rate. These can be vasovagal syncope. During urination, one can get syncope because especially if one is straining during urination, it increases vagal tone and decreases heart rate leading to syncope. Were you fasting for a long time, dehydrated, under stress or just came back from urination during the second time? We need to evaluate you. You should get an ECG done, and you may need a Holter monitoring after ECG. Get your blood pressure and pulse rate checked. You will also need echocardiography and get sugar test as well. In treatment, at this moment you should avoid risky activities like drinking and walk alone on the road. Do not strain during urination. Drink plenty of liquids like water, ORS (oral rehydration salt solution), fruit juices, etc. Avoid dehydration and prolonged fasting. Also, avoid smoking and alcohol if any.