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Unable to stand

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I am 41 years old, and a woman, in general good health. For the last 12 hours, I am not able to stand up for more than two or three minutes (and sometimes not more than a few seconds) before I begin the process leading up to passing out (things going black, experiencing sounds as though they are far away, etc.) Along with this pre-syncope, my legs go week and my breath becomes labored. So far, I've been able to lie down before actually fainting, but the labored breathing takes as long as 15 minutes of lying absolutely still (no exertion) to subside.

As for the breathing issue, I'm not sure "labored" is the right term. So I will describe: I am able to breathe, but my breaths are rapid and very deep, almost gasping. I can't control this as it's happening - it's some kind of automatic response to what seems like my body not being able to get enough oxygen. The last time I got up, after three steps, my breath was as described and there was pain in my chest. It resolved after about 20 minutes of lying down.

Again, if I do not exert myself long enough to recover, I able to sit up in bed and breathe normally without triggering the pre-syncope. It's once I stand up that it all goes to shit. :) When resting, as now, I feel weak, but otherwise have no other symptoms. I took a few glucose pills to rule out low blood sugar. Nothing changed.

These are somewhat scary symptoms, but given what's happening, I can't drive to an ER and I don't want the drama of calling an ambulance if this is nothing serious. And again, as long as I am at rest, I'm pretty much okay.

What are the possibilities of what could be causing this?


Category: Internal Medicine Specialist

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Expert:  Dr. Deepu Sebin Sebastian replied 4 Days ago

Hello,

Thank you for choosing DoctorSpring.

You should get medical help as soon possible. Do not hesitate to call the ER or call ambulance. This could be the manifestation of a cardiac failure. (among other possible causes ). As this is an emergency you should medical help as soon as possible.

Generally this could be due a Cardiac cause, Respiratory cause, or a Neuromuscular cause.
The symptoms that you have described of passing out on standing could be due to a drop in your blood pressure known as othostatic hypotension and it needs evaluation. To give you a more learned opinion I would like you to answer some questions. How would you describe the chest pain? was it sharp,squeezing or a heaviness? Have you been on any medications for hypertension diabetes, heart problems, or depression? Have you conducted any blood tests like fasting blood sugar, lipid profile recently and were they normal? Have you had any fever or cough with sputum?


1)ECG (must)
2)Cardiac Biomarkers (must)
3)Brain Natriuretic peptide
4)D-Dimer
4)Arterial and venous Blood Gas
5)Carbon Dioxide Monitoring -To see your ventilatory status.
6)Pulmonary Function Test -If all of the above come normal.

Kindly do not ignore your symptoms and do take help and get yourself evaluated immediately. Meanwhile lie down. You may also call your friends or family for help. I will keep this consult open indefinitely. So you please get in touch with the ER. Once the acute event is stabilised you can get back to me for followup.

Thankyou.


Dr. Deepu Sebin Sebastian
Category: Select Speciality
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
Dr. Deepu Sebin Sebastian and 4 other Medical Specialists are ready to help you

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