OpenHealth Q&A

Concerns About Blood Pressure and Heart Rate: Seeking Advice

I am a 25-year-old female, and as of my last weigh-in on Friday, I am 122.8 lbs. My current medications include: - Lamotrigine/Lamictal at a dosage of 150mg daily - Quetiapine Fumarate/Seroquel at 50mg, administered twice daily (one dose around 8:30 PM and another right before sleep, totaling 100mg each day). These medications are aimed at addressing mental health challenges, specifically bipolar disorder type II, with some potential indications of borderline personality disorder and anxiety. The quetiapine also assists with sleep. Aside from my mental health, I have been diagnosed with patellofemoral malalignment syndrome following an ankle fracture. Fortunately, I have not experienced any major injuries aside from that and a few minor stitches. There have been no surgeries or additional health issues to report. I intend to visit a healthcare provider once my insurance becomes active, but in the meantime, I seek some guidance regarding my symptoms to determine if they warrant serious concern. Lately, I've found myself experiencing dizziness, particularly when I stand up quickly, and this has become more frequent and intense. At times, I notice spots in my vision when I rise. Just this past Thursday, I experienced a particularly severe episode, feeling lightheaded and dizzy for the rest of the day. Some friends, whose acquaintances have Postural Orthostatic Tachycardia Syndrome (POTS), recommended that I monitor my blood pressure and heart rate, so I purchased an Omron blood pressure monitor, noted for its clinical reliability. When seated, my blood pressure usually hovers around 100/70 in the morning, with my heart rate in the high 90s to low 100s. By evening, my blood pressure typically drops to approximately 90/65, while my heart rate decreases to the 80s. According to my Samsung Watch5 Pro, my resting heart rate generally falls between 60 and 80 beats per minute. Curious about my symptoms, I decided to conduct the NASA lean test at home a few times. On each occasion, my blood pressure elevated into the hypertension range, reaching a peak systolic reading of 130/83 and a diastolic high of 121/86. Every time I completed the test, I experienced significant dizziness and lightheadedness upon standing, along with a pronounced sensation of my heart racing. There was a noticeable increase in my heart rate, typically fluctuating by 15 to 20 beats per minute from lying down to standing. By the seven-minute mark, I usually felt nauseous, but I’m relieved to say I have not fainted during any tests. Could this be classified as normal bodily reactions, or are these signals—dizziness, lightheadedness, visual disturbances, and nausea—indicative of an underlying issue? Should I consider this enough of a concern to seek urgent care, or is it something I can simply mention in my upcoming appointment with my general practitioner? Thank you for any insights you can provide!

Answers (1)

9/13/2025, 11:10:39 PM

OpenHealth AI

Your symptoms of dizziness, lightheadedness, and visual disturbances upon standing, especially when paired with fluctuations in blood pressure and heart rate, are valid concerns and warrant careful attention. Although it's good to monitor and understand these symptoms, there are specific steps you can take to manage this situation while awaiting your healthcare appointment.

Explanation

The symptoms you're experiencing could be linked to a few potential underlying issues, including:

1. Orthostatic Hypotension: This condition occurs when your blood pressure drops significantly when you stand up, leading to dizziness or lightheadedness.
2. Postural Orthostatic Tachycardia Syndrome (POTS): This can cause issues similar to what you've described, including an increase in heart rate and dizziness upon standing, but usually with a higher heart rate than baseline when standing.
3. Medication Effects: Both Lamotrigine and Quetiapine can have various side effects, including dizziness. It’s essential to evaluate whether these could be contributing to your symptoms.

Next Steps

1. Keep Monitoring: Continue to monitor your blood pressure and heart rate regularly, especially before standing up and after standing up. Note any patterns or changes in symptoms.

2. Hydration and Saline Intake: Increase your fluid intake and consider adding more salt to your diet if not contraindicated by other conditions or doctor recommendations. This can help raise blood pressure.

3. Gradual Movements: When you stand up, do so slowly. Sit up for a moment before standing and consider using compression stockings to help improve blood flow.

4. Record Your Symptoms: Maintain a diary of your symptoms, noting triggers, the severity of dizziness, heart rate changes, and how long the symptoms last. This log will be helpful for your healthcare provider in identifying any patterns or underlying conditions.

5. Monitor Your Response: If you experience any episodes of more severe symptoms, like fainting or prolonged dizziness that does not improve after resting, consider seeking urgent medical attention.

Conclusion

While it’s often not urgent, the combination of your symptoms should definitely be discussed in detail with your healthcare provider during your appointment. In the meantime, prioritize the steps above to manage your symptoms effectively. Take care, and don’t hesitate to reach out for immediate help if your situation escalates or you feel uncertain.