“I often feel dizzy. Could it be that I have carotid artery stenosis?”

Dizziness is very common in life and is also the main complaint of some patients when they come to see a doctor. So is the dizziness that often troubles middle-aged and elderly people caused by blood vessel blockage? Or is it caused by blood pressure problems? Today, let's talk about it through this article.

Many people come to consult me ​​about dizziness. The problem of dizziness is not that simple and cannot be answered categorically. There are too many reasons that can cause dizziness. I will analyze it based on the typical cases I have consulted before:

The patient was a 70-year-old female with hypertension. Her main complaint was dizziness, especially when she stood up from sitting or when she was about to stand up from lying down. The dizziness was more severe in the summer. In addition to the dizziness, her vision was blurred, her left leg felt weak when she walked, and she often dropped things she was holding.

The patient came to our hospital's neurology department for treatment due to dizziness. Examination showed severe stenosis of the left carotid artery. Later, the director of neurology recommended her to come to our department to solve the problem. Through face-to-face consultation, we found that the patient's dizziness might be caused by multiple factors.

First, the patient had severe stenosis of the left carotid artery, which was the main problem she was dealing with, but it was not the main cause of her dizziness. The patient's carotid artery stenosis increased from 50% to 80% over a three-year period, and surgical intervention was required to solve the stenosis problem in order to prevent possible symptoms such as cerebral infarction.

Secondly, the patient had a history of hypertension. He controlled his blood pressure to 90/60 mmHg through medication. Sometimes the low pressure was 48 mmHg. During the 4 months when he did not take medication, the high pressure reached 180 mmHg, so the patient insisted on using medication to control his blood pressure.

The controlled blood pressure may be considered normal for ordinary people, but the patient is 70 years old, and this blood pressure is too low for the patient. It is okay for the elderly to have slightly higher blood pressure, and it is no problem to control it at around 130mmHg. Moreover, the patient has carotid stenosis, and the brain is ischemic, so the heart needs to be pressurized to pump blood to the brain. If the blood pressure is too low, it cannot be raised, which may also cause the patient to have dizziness. The main manifestation of dizziness in patients is dizziness after changing body position, which is related to low blood pressure. Serious patients said that they had less dizziness during the period when the blood pressure was 180.

Third, the patient's examination showed stenosis of the left subclavian artery. Although this stenosis is not serious, it may cause dizziness. It is necessary to consider whether there is blood steal syndrome, which can also cause dizziness in patients.

Fourth, if you feel dizzy more often in the summer, it is because you have lost a lot of water and your blood pressure is low, which will also aggravate the symptoms of dizziness.

Taking all the above into consideration, I advise patients: the problem of carotid stenosis must be solved (if the carotid stenosis exceeds 70%, patients must deal with this problem regardless of whether they have symptoms or not). Because blood pressure will fluctuate during carotid artery stripping, the posterior circulation needs to be protected. Therefore, before solving the problem of left carotid artery stenosis, the problem of left subclavian artery stenosis must be solved first. Continue to pay attention to blood pressure issues after surgery. Blood pressure may decrease after surgery because the blood vessels are no longer narrow and the heart does not need pressurized blood supply, but blood pressure is also something that needs attention. It is recommended that patients go to the cardiology department for a face-to-face consultation to treat blood pressure problems after surgery. Patients with hypertension should follow the guidance of professional doctors on what medicine to take and how much dosage to take. They should not take or stop taking medicine without authorization.

Some young people often ask me, is dizziness caused by carotid artery stenosis? You can rest assured that this disease is an old age disease, and young people generally do not need to consider this issue. Dizziness in young people may be due to some vestibular problems, or it may be a benign incidental event, so there is no need to worry too much.