Feeling Dizzy and Nauseous While Standing: When to Seek Medical Help?

Q: Feeling Dizzy and Nauseous While Standing: When to Seek Medical Help?

Hello： Based on your description, your discomfort may be related to your heart and blood pressure. <br>It is important to rule out whether temporary arrhythmia is causing low blood pressure, which could lead to symptoms such as dizziness, blurred vision, and nausea. <br>I recomme

Sudden nausea and gradual loss of vision while standing for a long time?

Hello, doctor.
After dinner today, while waiting in line at the night market, I suddenly started feeling nauseous and even experienced a dry heave.
Feeling very uncomfortable, I moved to a nearby open area to squat down and rest.
After squatting, I felt better, but when I stood up and walked a few steps, my vision started to darken.
By the time I reached a nearby park, everything went black, and I felt dizzy, with cold limbs and cold sweat.
After squatting down and hydrating for about 10 minutes, I felt much better, but I still experienced slight dizziness on the way home.
Previously, I also felt nauseous while standing in line and felt much better after moving to a less crowded area and removing my mask to breathe.
I'm not sure if this is related, but I have also experienced sudden blackouts while standing on the train.
I wanted to inform you of these occurrences.
Do you think I need to seek medical attention, or is rest sufficient? I would appreciate your advice.
Thank you.

Cheng, 20~29 year old female. Ask Date: 2022/07/21

Dr. Lin Zhebin reply Family Medicine

Hello: Based on your description, your discomfort may be related to your heart and blood pressure.
It is important to rule out whether temporary arrhythmia is causing low blood pressure, which could lead to symptoms such as dizziness, blurred vision, and nausea.
I recommend that you consult a cardiologist.

Reply Date: 2022/07/21

More Info

Feeling dizzy and nauseous while standing can be concerning, especially if it has happened multiple times. Your symptoms, including dizziness, nausea, cold extremities, and sweating, suggest that you may be experiencing a form of orthostatic hypotension or a vasovagal response. Both conditions can lead to a sudden drop in blood pressure when standing, which can cause dizziness and nausea.
Orthostatic hypotension occurs when your blood pressure drops significantly upon standing up, leading to symptoms like dizziness, lightheadedness, and even fainting. This can happen due to dehydration, prolonged standing, or certain medications. On the other hand, a vasovagal response is a reflex that can occur in response to stress, pain, or prolonged standing, leading to a sudden drop in heart rate and blood pressure, which can cause fainting or near-fainting episodes.

Given your description of feeling better after sitting or squatting down, it seems that your body may be responding to the change in position, allowing blood flow to return to the brain. However, the fact that you have experienced this multiple times, especially in situations where you are standing for long periods, warrants further investigation.

Here are some recommendations on when to seek medical help:
1. Frequency and Severity: If you continue to experience these episodes frequently or if they worsen in severity, it is essential to consult a healthcare provider. Recurrent symptoms could indicate an underlying condition that needs to be addressed.

2. Associated Symptoms: If you experience additional symptoms such as chest pain, shortness of breath, severe headache, or neurological symptoms (like weakness or numbness), seek immediate medical attention. These could be signs of more serious conditions.

3. Duration of Symptoms: If your dizziness and nausea persist for an extended period or do not improve with rest, it is advisable to seek medical help.
4. Impact on Daily Life: If these episodes interfere with your daily activities or quality of life, it is important to discuss this with a healthcare professional.

5. Underlying Health Conditions: If you have pre-existing health conditions, such as heart disease, diabetes, or neurological disorders, it is crucial to consult your doctor, as these conditions can complicate your symptoms.

In the meantime, consider the following self-care measures:
- Stay Hydrated: Ensure you are drinking enough fluids, especially if you are in hot weather or have been sweating.

- Avoid Prolonged Standing: If you know you will be standing for a long time, try to take breaks or shift your weight from one leg to another.

- Gradual Position Changes: When moving from a sitting or lying position to standing, do so gradually to allow your body to adjust.

- Monitor Your Symptoms: Keep a diary of when these episodes occur, what you were doing at the time, and any other symptoms you experienced. This information can be helpful for your healthcare provider.

In conclusion, while occasional dizziness and nausea can be benign, recurrent episodes, especially with accompanying symptoms, should not be ignored. It is always better to err on the side of caution and consult a healthcare professional for a thorough evaluation and appropriate management.

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