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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Hypertension Or Hypotension

I have a condition called inappropriate sinus tachycardia which occasionally causes me to faint. Along with this illness I get high blood pressure. Last time I fainted someone I work with said that when I had landed she could see my veins pulsing. I always though that my blood pressure dropped prior to a faint as I go dizzy, very pale and get a kind of tunnel vision. Iam now unsure whether my blood pressure is high or low before I go down. Is it possible for it to drop then come back up very suddenly. Any help gratefully received.. Iam currently waiting to see my consultant but due to the great british NHS the next available appointment is october.
Sun, 20 Dec 2009
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The answer to this unfortunately involves talking about cardiac physiology. Blood pressure is a combination of cardiac output and your systemic vascular resistance of your arterial blood vessels. Cardiac output is made up of your heart rate multiplied by your stroke volume (the amount of blood that is ejected per beat). Your stroke volume is effected by something called venous return. Venous return is the blood that flows back into your heart from the venous blood system. Definitions over, on with the explanation. Your sinus tachycardia will cause your cardiac output to fall. This is because your heart is beating to quickly to let it fill in between each contraction. Your blood pressure will fall as your cardiac output is low. You faint because you have reduced blood flow to your brain. When you hit the ground your venous return will increase as more blood will be available to your heart. When you are standing the blood in your legs finds it hard to get back to your heart, but when you are lying down it doesn't have to overcome the force of gravity. Your veins pulse because you have an increased venous return. In summary, you will have hypotension when you faint and your pulsing veins are not an indication that your blood pressure is high but that your venous return is. Incidently the drugs that you are taking for your hypertension may not be helping. It might be worth seeing your GP to find out if these are still necessary.

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Hypertension Or Hypotension

The answer to this unfortunately involves talking about cardiac physiology. Blood pressure is a combination of cardiac output and your systemic vascular resistance of your arterial blood vessels. Cardiac output is made up of your heart rate multiplied by your stroke volume (the amount of blood that is ejected per beat). Your stroke volume is effected by something called venous return. Venous return is the blood that flows back into your heart from the venous blood system. Definitions over, on with the explanation. Your sinus tachycardia will cause your cardiac output to fall. This is because your heart is beating to quickly to let it fill in between each contraction. Your blood pressure will fall as your cardiac output is low. You faint because you have reduced blood flow to your brain. When you hit the ground your venous return will increase as more blood will be available to your heart. When you are standing the blood in your legs finds it hard to get back to your heart, but when you are lying down it doesn t have to overcome the force of gravity. Your veins pulse because you have an increased venous return. In summary, you will have hypotension when you faint and your pulsing veins are not an indication that your blood pressure is high but that your venous return is. Incidently the drugs that you are taking for your hypertension may not be helping. It might be worth seeing your GP to find out if these are still necessary.