by Anna Apostolo
Dehydration is one of the factors that are often underestimated. Postural changes can also play a role: blood pressure drops quickly when moving from a sitting or lying position to a standing position
I am 29 years old, I smoke 5-8 cigarettes a day, I don’t play sports and I have been splenectomized since the age of 4. Lately I have been feeling tired, confused, short of breath and, sometimes, rapid heartbeat. I always have blood pressure values around 90/60. I had an ECG, 24-hour dynamic Holter and stress test: everything was normal. What do the symptoms I suffer from depend on?
Anna Apostolo, assistant representative, Monzino Cardiology Center, Milan, responds (GO TO THE FORUM)
While high blood pressure is a widely discussed topic, low blood pressure is less covered in the medical literature because it is typically a benign and often asymptomatic condition. In numerical terms, an individual suffers from hypotension when resting blood pressure falls below 90/60 mmHg. This condition does not entail particular risks, unless it causes hypo-perfusion of the organs. It is common in young people, especially women, and is more common in summer, since the heat favors the dilation of blood vessels. The drop in blood pressure is often accompanied by tiredness, drowsiness, difficulty concentrating, weakness in the legs, ringing in the ears and dizziness.
Dehydration
In the event of a more sudden reduction in blood pressure values, pallor, nausea, cold sweat and blurred vision may occur, sometimes harbingers of imminent fainting. Generally the causes of the drop in blood pressure are not worrisome. For example, dehydration is one of the triggering factors that are often underestimated. When the body does not receive enough fluids, blood volume decreases, which in turn results in a reduction in blood pressure. Postural changes may also play a role. In orthostatic hypotension, blood pressure drops rapidly when moving from a sitting or lying position to a standing position. This reaction may result from a failure of the nervous system to adequately respond to postural variation.
Useful exams
In these cases it is important to avoid standing in the same position for a long time, or getting up abruptly from a sitting position or from bed. To complete the investigation into the causes of your symptoms, you may carry out blood tests (blood count, renal function and plasma electrolytes, thyroid and liver function). An echocardiogram may be helpful. The palpitations you report could be a physiological reaction of increased heart rate or extrasystoles which, if sporadic and short-lived, do not cause concern.
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February 19, 2024 (changed February 19, 2024 | 10:45)
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