How to Perform Orthostatic Hypotension Testing
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- เผยแพร่เมื่อ 29 พ.ย. 2014
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Disclaimer: the information in this video only represents the knowledge and property of the video’s authors- no one else. - วิทยาศาสตร์และเทคโนโลยี
Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within 3 minutes of standing when compared with blood pressure from the sitting or supine position.
After the patient stands, the B/P should be taken at 1 minute and 3 minutes. Also, the arm should be at heart level, not hanging down.
Do a video and explain to us please since you seem to know better
I'm so glad to see someone say this. My Postural Drop is always at the 3 minute mark which is why it was missed for so many years. My heart rate races up on standing, my blood pressure remains the same. A few minutes later my heart rate settles and then I almost pass out with very low BP.
I would say, place the cuff on the left arm (closest to the heart and the cuff would be at heart level). Holding the arm up isn't a relaxed position and is never a good idea for measuring blood pressure. The arm hanging down isn't a problem.
i don't know if i have OH, but i get dizzy after i stand up for a few minutes, and my bp drops!
@@laurenm162 You seem young to get it. Get it checked out I would say.
Yes! I can tell this to my doctor the next time I go!
For me sometimes I stand up and have what feels like a mini seizure and zone out.
Me too i have blacked out twice almost fell down the stairs
Instance I’ve blacked out a lot of times, but I also have a problem drinking enough liquid. One thing I have found that can stave it off is when you feel it coming on start hyperventilating. You may still be a little foggy for a few seconds, but stops the complete disconnect from reality you get for a few seconds.
sometimes after standing up i would blackout then get a small headache then i would lose my balance and i i can't walk properly for a few seconds
@@ikgtrinity6984 i had a memory that i went to the bathroom then i woke up and my hand was hurting i was blacked out next to my stairs
P.o.t.s syndrome
Thank you. Very helpful!
Thanks for the videos. Can you guys please, make some quick head to toe examination videos for cs exam? ☺
This video is incorrect I would not preform your tests this way
I've scared my family with this alot as they call it playing possum. Im not sure if its Orthostatic Hypotension or not but it seems like this might be the case till i can properly be examined All I know is I get up, my vision goes dim, I go right to the ground. I feel no pain, I wake up
I just wondering why I got hypotension whenever I'm on my first day on period..what does that means? it doesn't happen every month ,maybe after
3 - 4 months after it happened ...and i would throw up everything that enter my mouth .i can't even drink plain water..then i end up in ER ...I'm confused between gastric or hypotension because when this happens my BP would drop so much,the doctor would ask me if I have low BP?...
i’ve had this for the past 4 years now i think? it’s not all the way better but it’s definitely tolerable after seeing a cardiologist who prescribed a couple medications to help, and drinking a lot of water! can’t stress the water part enough especially in the summer. but if you’re having issues like i did where it goes black when you stand up, you feel heavy all over, dizzy, weak, or you pass out- definitely go to your doctor. before getting all of this figured out i could barely get through a day of school without passing out. and with living in AZ, the 95+ degrees days were god awful. if anyone has questions pls let me know!
I know I’m a bit late but today when I stood up to get a drink about half way across the room my vision went all fuzzy but I had had this symptom for about a year so thought it was normal but then it stayed fuzzy and I thought I was still standing and once my vision cleared I was on the floor.
I hope you'll get this. My daughter has been going through this on and off for several years, but just a few months ago it got so bad that she wanted tocbe seen for it. They have done an EKG and had a 24 hour heart monitor put on her and they both came back normal. A cardiologist looked at the results. The doctor is saying no further cardiac tests need to be done at this time but she is still having symptoms. I feel like taking her straight to the hospital and see if further tests can be run on her. It seems like her doctor is starting to shrug her off. 😔 I just want to help her. She just turned 20 and can't even work because of her symptoms. She wants to get a job so bad but doesn't feel like she can. Is there anything else you recommend for her?
@@shannonmejia3626Have they offered your daughter a tilt table test? Have you heard of a condition called POTS?
If you have this as a persistent, chronic symptom, ask your doctor to do orthostatic testing and look at possible causes.
It’s true that all human being will experience orthostatic intolerance and presyncope occasionally onnstanding, but persistent, severe or chronic symptoms are not normal and should not be dismissed, especially when the symptoms cannot be explained by the circumstances or resolved with simple first aid.
Dr Peter Rowe has some excellent lectures on this topic.
There are three variables that reflect orthostatic intolerance: blood pressure, heart rate and cerebral blood flow. These can be deranged in different patterns.
A drop in cerebral blood flow can be inferred from orthostatic intolerance and presyncope/syncope symptoms, but can only be measured using transcranial Doppler ultrasound in conjunction with a tilt table test conducted at an autonomic lab.
proud of you, thanks
Is it normal to like the feeling of lightheadedness when this happens? Feels trippy.
Carlos Leon same
Carlos Leon I'm not sure if it's normal
It’s a symptom of an abnormally low blood pressure level
I love it lol it's like a small high
Feels like you popped some shrooms vision gets blurry and shit and everything hits like slow mode
When i stand up. I cant see anything. It went all black, i cant take a stel for like 5 or 6 seconds. What do you think doc? Should i meet the doctor now?
I think you should. I fainted once from standing up and seeing the doctor helped me a lot.
This happens to me. Do you also start shaking sometimes uncontrollably? This happened to me today as I stood up fast and went to the bathroom and I before I blacked out for a few declines I felt my body shaking.
@@TinyHorse_ you mean physically shaking? Or simply felt like your body is shaking like someone is rattling your whole body inside a pringle box spinning clockwise + counter clockwise very fast?
CGK id say like physically
Why the same exact shit happens to me im only 14 bruh
How can I sleep 😴 with LBP ? Please help , I’m scared I might pass out in my sleep , my hearts beats so slow
I lay with my back against the bed I have a feeling of loosing balance in my head wat could that be
Sometimes when I stand up from sitting and lying down, my vision slowly goes black.
Yes for 3-5 seconds. pls help
So whenever I stand up which is a lot throughout my day I feel like I can’t see and I feel like I’m about to loose my balance I’m only a teenager and I’m a healthy person, also a couple of days ago I almost passed out after I got up I fell into a counter and caught myself should I see my doctor about this?
same thing with me, you should tell your doctor about it. i did and they had me do a blood test to see what was causing it.
@@dotssyn o ok thanks
I had it happen badly for me this morning. I got up and started to have the usual symptoms but then i blacked out then woke back up because i had fallen and hit my back on an object in my closet. Don’t remember anything between when it started and when i came to my senses after falling
So what was your diagnosis..did u consult the doctor because same thing happened with my father
My vision started getting dark and it was hard to hear, my arms and legs feel heavy and it was kinda hard to move, it was sooo trippy, I went downstairs to tell my parents and I almost fell
How to cure it pls tell.Im 16 and very stresed
@@HarshilHandoo-cm5gk just get more sleep and don’t get up to TOO fast after laying down
@@Gabeiscool ok thanks
@@HarshilHandoo-cm5gk no problem :)
@@HarshilHandoo-cm5gkhow are u noe
I would say, place the cuff on the left arm (closest to the heart and the cuff would be at heart level).
the compensatory mechanism should be the bp raising a little bit not going down or staying the same, this should be revised
I get severe headrushes whenever I rise up. I did this and my BP went from 100/61 - Lying down to 104/62 sitting to 108/76 standing up. What does this mean? 😭😭😭😭😭 I'm so tired of falling back down to the floor whenever I try to get up.
Poss req to see a cardiologist for an EKG and evaluation.
Please offer accurate BP readings, which are in even numbers when using a manual cuff.
+Valery Burkholder Or face the wrath of the law! It is technically considered falsifying patient records, which is ridiculous since the margin of error in measurements for manual cuffs exceeds 1.0mmHg.
Wrath of the law. :) now, auto BPs have their own rules. They are the radical bastards of the medical tools. Hahha. I posted this a while ago. Forgot all about it.
+Valery Burkholder If he rounded it to the nearest 5 mm increment which I think he did then its the right thing to do.I have watched a video of clinical exam where the doctor said we should round it off.This is what he Dr said"Its very important to measure the BP to the nearest 5 mm Hg because if you were to say a BP of 127/79 this implies a false sense of accuracy."
shhhhhh..... don't speak valery. just don't speak.
we are both physicians. we regularly use BPs that are odd numbers. even when using a manual cuff
i have this what do i do?
Very informative
Lol my doctor did this and it turned out I didn’t have it, but I’ve dealt with all the symptoms of orthostatic hypertension for many years now. I haven’t went to the doctor for it again, it’s been almost two years since I last went. It’s affecting my life and I’ve gotten hurt from fainting. Should I go check it again?
Maybe get checked out for POTS
Ask to be referred to an autonomic specialist. They have specialised equipment and testing techniques to investigate fainting and orthostatic intolerance. Unfortunately there aren’t very many such specialists, so there may be a long waiting list.
After I woke up (laying down) I took a long shower (standing up) and I got light headed.. breathing difficulties and I blacked out (fell)
Same bro o also blackout when I suddenly stand up
Don't take long showers in hot water. It limits your oxygen intake
I got a really bad one today. I literally passed out for about 3 seconds, my tongue started burning, and when it was done I felt like I had just woken up from a dream, after that I got really confused and started wondering if I was awake or not, that shit was honestly kinda scary.
Wtf dude we're same this is what happened so i stand up quick to arrange the curtain and then i just passed out like 2 or 3 second and i felt too that i just woke up from a shit dream after that i got confused too and i took a look on my wall it broke bcus i collapse there (bad Grammar)
My bp shoot's up upon standing and drops while siting and laying down.. so please explain that
gimme solid numbers.
Called orthostatic hypertension
I got the same thing and sometimes it can get way up there..
Hyperadrengenic pots
I always get so dizzy after standing up and my vision gets black. I also blacked out a few times. Is it necessary to go to the doctor?
Naw, doctors don't know a thing! Smoke a blunt and that will constrict your blood vessels enough so your BP don't drop so much. Sometimes you need a bump of cocaine to get the heart pumping too.
Its in increments of 2 how did he get 115
And my legs are not pooling blood
How do i treat it? I almost broke my neck because of this.
Try 1minute sitting down, don't just stand up after lying bed, and take exercise and take alot water
I had it happen right now i stoops up and felt so dizzy i feel on my head and dropped my food.I didn't even realise it was me that fell. It was really weird
be careful kiuu!
I held my breath when things started getting fuzzy went close to the ground so I won't fall then it felt like a had a seizure my head kept going up and down and it hit the floor about 7 times and it hurt it was very weird I did not know what happend
wow that's wild man
It would have been helpful to have a patient that has the problem.
was he placing the stethoscope at the brachial artery? it should be more medial right?
5yrs as an EMT .. about 5-8 patients a day and required to take BP for every patient at least twice... taking BP doesn't always need to be so precise to get an accurate reading.
you're supposed to place it on the brachial artery.
Place it where you hear the beat. If you don't hear anything you got it wrong. It ain't that deep.
I was suffering from Hypertension and my blood pressure did never become stable. I usually had headache especially in the morning and was taking antihypertensive drugs but did not want to continue with the same. One day I discussed this problem with one of my friend. He told me about Planet Ayurveda, we visited there, consulted Dr. Vikram Chauhan, Dr. Vikram prescribed me with "Hypertension care pack". I am much better now and my B.P is also under control.
My bp was 70 over 40 getting out of hot tube on a cold day
Great example. The light headed feeling is likely from the brain not being perfused adequately!
@@MedSchoolMadeEasy so that's heart disease?
Without a full cardiac workup, it's impossible to say it isn't heart disease. However, hot tubs cause vasodilation which can cause blood to pool in the veins transiently causing a lower blood pressure.
So this mean I'm luck water?
I having this 2 months now I thought its normal damn
who else is here bc they feel like they have it? I went to the doctor and explained my symptoms and she's like 'its a universal experience' then tried to convince me to go on the pill. When i stand up my my vision dissapears, my heart pumps soo much to the point i can feel it pounding in my whole body and i get a headache. I get neck pain and i cant hear anything. My mum was talking to me when it happened once, her voice sounded like it was underwater and not english. I usually collapse slowly then forget where I am for a few seconds.
I’d suggest seeing a different doctor, explaining your symptoms, and asking for a NASA lean test or active stand test.
Arm should be raised
I have this. One time I stood up and fainted.
If it only has happened once, and has not had lesser episodes, you were probably dehydrated that day.
@@ikgtrinity6984 Yup, doctors said I was low on blood sugar and super dehydrated. Mainly due to excessive running followed by inadequate water consumption. However, one time I was with a friend and we were high on thc. I had another episode it was very scary. I could feel my senses fading (vision and touch). I thought I was gonna die.
Same happen to me just now
i have this shit.
If you suspect that a patient may have Orthostatic Hypotension, do you want to make safety precautions in case they faint and fall? Do you want to be in front of the patient in case you need to catch them?
definitely! always
Some physicians recommend standing for 5 to 20 minutes.
cool!
which heart disease causes orthostatic hypotension?
Low Cerebrospinal Fluid
Chocolate allergy
Dehydration can cause this
It doesn't have to be a heart disease. Postural Orthostatic Tachycardia Syndrome (not well known, but as they learn more it appears to be far from unusual, it's just not diagnosed often) which is a form of dysautonomia can cause this. Heart rate must increase at least 30bpm for an adult going from supine to standing and stay high for several minutes for diagnosis. Hypotension may or may not be present as well (it is for me).
@@kirstendurfee7162 same here. My blood pressure stays normal but I get palpitations and fast heart rate when I stand and I do get light headed. They say it can also be a nervous system problem
Isn’t orthostatic hypotension whenever you get up from a seat, you feel dizzy and your vision goes a bit funny and feel a bit warm ?
sounds like the symptoms of it, yep!
U should allow for time to pass, Dr!
thanks ochrechap!
@@MedSchoolMadeEasy There should be a 3min gap between measurements
Not specifica on how to...just a few minutes os not specific
The classic “odd number bp reading” on the sphygmomanometer with only even numbers lol fakeee
thanks Dill!
Ignore this video entirely incorrect
This isn't accurate. There should be no reading taken in the seated position. It goes straight from laying to standing. Also, exact BP are important! There are so many things off here I just can't! Just find another video, is my recommendation.
Lying, Sitting, Standing is the standard of practice that has been taught in nursing school for years.
These guys are so cute 😩😍😘😘😘