How can my mother manage dizziness and hypotension at 70?

Question

Hi doctor,

My mother, aged 70, experienced dizziness. When we checked her blood pressure, it was on the lower side at 90/54. She had been taking Telma 40 mg both in the morning and evening. After consulting a local doctor, we were advised to skip the morning dose and monitor her blood pressure.

However, later she complained of a feeling of heaviness in her head, and when we checked again, her blood pressure was high at 181/83. She also vomited. We then gave her Telma and took her to the hospital, where a CT scan of the brain, blood tests, and an ECG were done.

What could it be?

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

I have reviewed your mother’s reports. Her primary issues are dizziness and fluctuations in blood pressure.

The low blood pressure reading is likely erroneous. Her dizziness is more likely due to elevated blood pressure, as suggested by the micro-ischemic changes seen on her CT (computed tomography) scan.

To accurately assess these fluctuations, I recommend 24-hour ambulatory blood pressure monitoring, along with Holter monitoring to rule out any cardiac rhythm abnormalities. Although the ECG (electrocardiogram) you shared is normal, there is a possibility of transient arrhythmias at her age, which can cause both dizziness and blood pressure fluctuations. If an arrhythmia is detected and appropriately managed, her symptoms may resolve.

I also recommend an echocardiogram to rule out structural heart issues, particularly valvular heart disease.

All other investigations, including the ECG, complete blood count, renal and thyroid profiles, blood sugar, and HbA1c (glycated hemoglobin), are within normal limits.

Please also address other potential causes of blood pressure fluctuations, such as medication non-compliance or anxiety. In addition, consider other causes of dizziness apart from blood pressure issues, including vision problems, ear disorders, or cervical spine conditions.

The reports you shared (the attachments were removed to protect the patient's identity), do not indicate any serious health issues at this time.

I wish your mother a swift recovery.

I hope this has helped you.

Please feel free to reach out to me again for further queries.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I understand your concern.

If she is stable now, the echocardiogram can be done later. However, an echocardiogram is an easily available test and can be completed within 20 minutes at any good healthcare facility.

Once the above-mentioned investigations are done, you are always welcome to discuss the results with me.

I hope this has helped you.

Please feel free to reach out to me again for further queries.

Thank you.