Understanding Dizziness
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 either due to a transient drop in blood pressure or an abnormality of heart rhythm.
Dr Navin Chandra evaluates patients presenting with dizziness 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. A precise diagnosis is the cornerstone of effective and targeted treatment, and can provide patients with significant reassurance regarding their underlying cardiac health.
Symptoms
- 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
Common Cardiac Causes
- Orthostatic (postural) hypotension
- Vasovagal (neurocardiogenic) syncope
- Bradycardia or heart block
- Sick sinus syndrome
- Ventricular tachycardia
- Aortic stenosis or hypertrophic cardiomyopathy
Diagnostic & Treatment Options
Establishing the cause of dizziness 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 and ensures the diagnostic pathway is both efficient and patient-centred.
- Resting ECG and rhythm assessment
- 24-hour blood pressure monitoring
- Head-up tilt-table testing for syncope
- Implantable loop recorder (ILR) for unexplained blackouts
- Echocardiography to assess valve and muscle function
- Permanent pacemaker implantation for bradycardia
- Medication review and adjustment
- Lifestyle guidance for vasovagal episodes
Frequently Asked Questions
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 dizziness or 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. Dr Chandra evaluates both presentations with equal diligence.
Could my blood pressure medication be causing my dizziness?
Yes. Several commonly prescribed cardiovascular medications — including antihypertensives, diuretics, and certain beta-blockers — can cause dizziness, particularly on standing (orthostatic hypotension). Dr Chandra routinely reviews a patient’s full medication list as part of the dizziness assessment and 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 dizziness or blackouts are directly attributed to a clinically significant slow heart rate (bradycardia) or heart block that cannot be resolved by adjusting medication. The decision to implant a pacemaker is made only after thorough investigation confirms a causal relationship. Modern pacemakers are small, reliable, and require minimal lifestyle restrictions once implanted. Dr Chandra will guide patients through this process in full.
Should I stop driving if I have been experiencing blackouts?
In the United Kingdom, DVLA regulations specify that patients who have experienced an unexplained blackout or collapse must notify the DVLA and refrain from driving until the cause has been identified and adequately treated. Dr Chandra advises all patients on DVLA fitness-to-drive standards as part of the clinical consultation and provides supporting documentation to the DVLA where required.