Dizziness is common and usually not serious. A faint while exercising or lying down, or one that comes with chest pain or palpitations, needs 999. Dr Navin Chandra looks for heart rhythm and blood pressure causes of light-headedness and blackouts at clinics in Ascot, Slough, Windsor and Wexham.
| Question | Answer |
|---|---|
| Common symptoms | Feeling light-headed, faint or off-balance, near-fainting, or blacking out |
| How it’s diagnosed | Your account of each episode, blood pressure checks, an ECG, monitoring and sometimes a tilt test |
| Treatment options | Fluids and posture changes, a medicine review, or a pacemaker for a slow heart rhythm |
| When to seek urgent help | Call 999 after a faint while exercising or lying down, with chest pain or palpitations, or if someone cannot be woken |
What Is Dizziness, and How Is It Different From Fainting?
Dizziness is a broad term encompassing light-headedness, unsteadiness, near-fainting (pre-syncope), and, in some cases, complete loss of consciousness (syncope). From a cardiac perspective, these symptoms can arise when the brain receives insufficient blood flow. This may be due to a transient drop in blood pressure or an abnormality of heart rhythm.
Dr Navin Chandra evaluates patients presenting with light-headedness and syncope to determine whether a cardiac cause is responsible. Conditions such as postural hypotension, arrhythmias, structural heart disease, and neurocardiogenic syncope all require specific and distinct management approaches. Finding the cause guides treatment and can be reassuring.
In pre-syncope you feel faint but stay conscious. The NHS guide to fainting says a faint is not usually serious, but a GP should still check it.
Heart and Blood Pressure Causes and Risk Factors
The heart and circulation causes Dr Chandra assesses include:
- Orthostatic (postural) hypotension
- Vasovagal (neurocardiogenic) syncope
- Bradycardia or heart block
- Sick sinus syndrome
- Ventricular tachycardia
- Aortic stenosis or hypertrophic cardiomyopathy
Not every case starts in the heart. Feeling off-balance with hearing loss or ringing in the ears points to the inner ear. Light-headedness that begins after a new prescription can be a side effect of that medicine.
Faints are more likely when you are dehydrated, too hot, or have not eaten or drunk enough. Some people develop low blood pressure as they get older, and some medicines lower it too.
Symptoms of Light-Headedness and Fainting Spells
- Light-headedness or faintness on standing
- Sudden brief blackouts or loss of consciousness
- Dizziness associated with palpitations
- Unsteadiness during or after exertion
- Prolonged dizziness at rest or with head movement
- Near-fainting (pre-syncope) without full blackout
| Red-flag symptom | Go to |
|---|---|
| Not breathing, or cannot be woken within 1 minute | 999 |
| Not fully recovered, or difficulty speaking or moving | 999 |
| Chest pain, or a pounding, fluttering or irregular heartbeat, with the faint | 999 |
| Fainted while exercising, or while lying down | 999 |
| Shaking or jerking (a seizure), or a serious injury from the fall | 999 |
| Fainted once and now feel well | GP |
| Light-headed with hearing or vision changes, or numbness or weakness in the face, arms or legs | GP |
Do not drive to A&E after a faint. If you are unsure how urgent it is, call NHS 111.
Standing Up Slowly: Postural Drops in Blood Pressure
Feeling faint as you stand or sit up suddenly is often caused by a quick drop in blood pressure. This is called postural hypotension. The NHS lists it as the likely cause when symptoms come on with a change of position.
Simple habits can help. Get up in stages, from lying to sitting to standing. Drink more water, avoid standing still for long periods and do not bend down suddenly.
Blood pressure tablets and water tablets can add to the drop, as the FAQs below explain.
When to See a Specialist About Blackouts
NICE advises urgent heart assessment, within 24 hours, for anyone who has blacked out and also has:
- an abnormal ECG
- heart failure
- a blackout during exertion
- a family history of sudden cardiac death younger than 40 years, or an inherited heart condition
- new or unexplained breathlessness
- a heart murmur
For those aged over 65, NICE suggests the same 24-hour referral after a blackout that came without warning. Repeated faints, or a faint at the wheel, are further reasons to see a cardiologist.
How the Cause Is Diagnosed: ECG, Monitoring and Tilt Testing
Establishing the cause of these symptoms requires a systematic approach. Dr Chandra undertakes a thorough clinical evaluation, including a detailed account of each episode, triggers, and associated symptoms. This history guides the choice of investigations.
- Resting ECG and rhythm assessment
- 24-hour blood pressure monitoring
- Head-up tilt-table testing for syncope: you lie on a bed that tilts you almost upright while heart rate and blood pressure are recorded. The tilt lasts 15 to 45 minutes of a visit of 1 to 2 hours.
- Implantable loop recorder (ILR) for unexplained blackouts: a small recorder under the skin. How it works is explained under heart rhythm management.
- Echocardiography to assess valve and muscle function: an ultrasound scan, covered under cardiac imaging.
When a rhythm cause is suspected, NICE advises a heart monitor before any tilt test. The type depends on how often the blackouts happen.
Treatment Options for Heart-Related Light-Headedness
- Permanent pacemaker implantation for bradycardia: for a heart that beats too slowly or pauses. Dr Chandra fits pacemakers himself. Read when a pacemaker is given.
- Medication review and adjustment: a change of dose or medicine when tablets are lowering blood pressure too far.
- Lifestyle guidance for vasovagal episodes: fluids, care with posture and steps to stop a faint as it starts.
Living With Fainting Spells: Driving, the DVLA and Prevention
While you feel light-headed, lie down until it passes and then get up slowly. Drink plenty of water. Do not drive, climb a ladder or use heavy machinery until it has gone.
When a faint seems to be coming, get flat and lift your legs. Failing that, sit and drop your head between your knees. The NHS also suggests crossing your legs, rocking up on your toes, clenching your fists or taking a drink of water.
Car drivers must tell the DVLA if a blackout affects their driving, as the gov.uk page on blackouts and driving explains. If a heart cause is found, Dr Chandra explains the options for treating it.
Why See Dr Chandra About Dizziness?
- NHS roles: he works for Frimley Health NHS Foundation Trust and is an honorary consultant cardiologist for Royal Brompton and Harefield.
- Pacemakers implanted by him: for blackouts caused by a slow heart rhythm.
- Tests arranged: ECG, blood pressure monitoring, tilt testing and loop recorders.
- DVLA support: he advises on fitness to drive and can provide information the DVLA asks for.
- Inherited conditions: a research interest, relevant when a relative died suddenly.
Where Dr Chandra Sees Patients With Blackouts
| Location | Address |
|---|---|
| The Parkside Suite, Heatherwood Hospital | Brook Ave, Ascot SL5 7GB |
| The Parkside Suite, Wexham Park Hospital | Wexham, Slough, Berkshire SL2 4HL |
| BMI Princess Margaret Hospital | Osborne Road, Windsor, Berkshire SL4 3SJ |
| Spire Thames Valley Hospital | Wexham Street, Wexham, Buckinghamshire SL3 6NH |
Clinic days vary by hospital, so check on 020 7099 9685 or at enquiries@navinchandra.co.uk before you travel. Out of hours, NHS 111 can help with an urgent worry. A collapse or other emergency needs 999.
Paying for a Dizziness Consultation: Fees and Insurance
| Part of the assessment | Fee |
|---|---|
| Consultation | Quoted when you book |
| ECG and monitoring | Quoted when you book |
| Tilt test or loop recorder | Quoted after the consultation |
No fees are published. Every 2026 fee is set out for you at the time of booking. Self-pay is available. Insured patients, for example with Aviva, Cigna, Healix or WPA, should confirm cover first.
FAQs About Dizziness and Fainting
What is syncope and how does it differ from dizziness?
Syncope refers to a transient, complete loss of consciousness due to a temporary reduction in blood flow to the brain. It differs from light-headedness (pre-syncope), in which the patient feels as though they may faint but does not lose consciousness. Both warrant cardiological assessment, as the underlying causes and risk implications can be significant.
Could my blood pressure medication be causing my dizziness?
Yes. Several commonly prescribed cardiovascular medications — including antihypertensives, diuretics, and certain beta-blockers — can cause light-headedness, particularly on standing (orthostatic hypotension). Dr Chandra routinely reviews a patient’s full medication list as part of the assessment. He will adjust treatment where appropriate to minimise side effects whilst maintaining cardiovascular protection.
Is a pacemaker required for dizziness caused by a slow heart rate?
A pacemaker is indicated when light-headedness or blackouts are directly attributed to a clinically significant slow heart rate (bradycardia) or heart block. This applies when the slow rhythm cannot be resolved by adjusting medication. The decision to implant a pacemaker is made only after thorough investigation confirms a causal relationship. The procedure is usually about an hour long, done under local anaesthetic. Dr Chandra will guide patients through this process in full.
Should I stop driving if I have been experiencing blackouts?
You must tell the DVLA if a blackout or faint affects your driving. The NHS fainting page adds that, after a GP referral to a specialist, you must not drive until that assessment has happened. Drivers of buses, coaches and lorries have to report any blackout or faint to the DVLA. Dr Chandra explains which rule applies to you and can provide information the DVLA asks for.
Can heart problems cause blackouts?
Yes. The NHS lists heart problems among the causes of fainting. A very slow or fast rhythm, or a narrowed aortic valve, may briefly stop enough blood getting through to the brain.
Why do I feel faint when I stand up?
Usually because your blood pressure dips for a moment as you rise. This is postural hypotension. Standing up in stages and drinking enough water can help. If it keeps happening, or you fall or black out, see your GP.
Can anxiety cause light-headedness or fainting?
Yes. The NHS lists stress and anxiety among the causes of feeling light-headed. Being very upset, angry or in severe pain can also bring on a faint. Any blackout without warning still needs a heart check.
Book a Dizziness Consultation with Dr Navin Chandra
- Phone: 020 7099 9685
- Email: enquiries@navinchandra.co.uk
- Online: request a slot through the appointment page, or ask first via the practice contact form
A faint with chest pain, during exercise or while lying down needs 999, not a booking. Related pages cover a racing or fluttering heartbeat, faints during sport through sports cardiology and other symptoms.