Dizzy after working out? VVS?

I'm 33 year old male, received PM for heart block, and syncope- also have a high vagal response. Also just 2 weeks ago hit my 1 year anny with my pacer! Things have been pretty great until this last week.

Thursday went for a 3 mile run (I run 2 to 3 miles a day) and as soon as I got done running I bent over and tied my daughter's shoe. I stood up and BAM....super dizzy and nauseous. Laid down with feet up for 10 minutes and ate dinner, then felt 100% back to normal.

Today (Memorial day) went for a 6 mile bike ride and as soon as I got done bent over to get my daughter out of the carriage on the back of my bike and BAM...dizzy, nauseous, tingling feeling all over...very similar to syncope episodes I would have prior to PM insertion. Laid down for ~ 30 minutes, ate some more food and feel much better (although kind of wiped out from it). 

Talked to the cardio on call and they said it sounds like BP is plummeting (something they mentioned when I first got it that I may be a candidate for Vasovagal syncope or neurocardiogenic syncope) but never really tested me (tilt table) or put me on meds for BP. But my PM looked great in the remote interogation. I've never had any problems until this week? I'm going in tomorrow hopefully to get an update with my cardiologist as they said ER trip not needed today.

Has anyone else had this?

Both times I was well hydrated. Although I was excercising on an empty stomach and food seems to bring me back to life quickly (I'm not diabetic but I'm always snacking bc when I get hungry I can get light headed). Both times I bent down and stood up? What's weird is I rand both Friday - Sunday and never had one problem. 


Almost EXACT same here!!

by arentas80 - 2020-05-25 20:33:49


I got my PM in Dec 2019 for Sick Sinus Syndrome. Since then I've been feeling worse. Lately I've been experiencing almost exactly what you're going through. Anytime I bend down and come back up, I'm dizzy/lightheaded. I was cleaning my house the other day and felt just fine. I bent over to clean my glass coffee table, came back up and BAM! I was light headed, tingly and nauseous for like 90 mins. I bend over to clean my dogs paws, come back up and BAM! I'm dizzy/lightheaded. It's AWFUL! I'm also struggling with exercise. Once I start I get this tingling all over as if my body isn't regulating its temperature correctly or something. I don't even sweat the same. Then after doing minimal exercise I get super weak sort of like a diabetic even though I'm not. I have to pound water and eat something sweet like fruit or a cookie. Eating or snacking ALWAYS makes me feel better.... When I'm hungry I can feel really weak as well. As soon as I eat something it helps almost immediately. 

I have a TILT TABLE Test on Wednesday of this week. I'll definitely let you know what I find out. I also feel weird when I sleep on my sides. I don't breathe well, I get this rush in my body and just feel uncomfortable. It's so hard to explain. Anyhow I'll keep you posted but I DEFINITELY know how you're feeling. Push for the Tilt Table Test ASAP! That's the standard test for this kind of thing. All the best! 



by happy2bealive - 2020-05-25 22:26:26

Wow- that is dead on very similar. I hate that tingling feeling (and nauseous and dizzy), the worst. 

Really eager to hear how the tilt table test turns out. I'm calling the cardio in the morning and going to request it as well! Hang in there man- it was comforting to hear from the cardio today that she didn't think it was life threatening, but obviously want to figure it out.

Exercise-induced Hypotension

by IAN MC - 2020-05-26 05:12:07

Occasionally , but not always, after running I  felt quite dizzy particularly after standing up from a sitting position.

I have been unable to reproduce this after  treadmill tests ( Sod's Law )

My cardiologist labelled it as " exercise-induced hypotension " and suggested that I  :-

-  Increase my hydration considerably before , during and after the run. This means drinking what I consider to be enough and then some !

- Increase my salt intake before and immediately after the run.

Doing this has solved the problem for me almost all of the time

I believe that exercise-induced hypotension is caused by dilation of the peripheral blood vessels. If this is  persistent it can lead to an increased risk of cardiac events so it is best to seek medical advice but , in my case, the simple measures described above were sufficient.

Best of luck




Vaso vagal reflex hypotension and fainting

by Selwyn - 2020-05-26 06:57:09

Exercise causes the blood vessels to dilate ( as heat is exchanged) . Unless the heart rate rises, blood pressure will fall.  With a sick sinus and pacemaker your heart rate tends to lag a little in response to physiologicial change. It is not uncommon to get a little dizzy if you exercise sit down ( to let your heart rate settle), your blood vessels are dilated a lot longer as you have not cooled down, you are also a little dehydrated ( from sweating during exercise), you stand up ( suddenly), your blood pressure drops ( as your heart rate is static), and you get dizzy .

The above happens to me on a regular basis after exercise associated with sitting down and waiting for my wife to finish off her exercise, I then stand up to leave and get postural dizziness - this is transient. I may have to stop walking or I am in danger of falling.

Now, what makes this scenario worse? Bending down, squashes the blood volume and reduces the venous return to the heart. As you hold your breath ( if that happens when you strain) this worsens the venous return. Standing up suddenly induces a fall in blood pressure , the heart is slowed with the venous return ( and for you your sick sinus/pacemaker) and ...you are in danger of fainting ( a vaso-vagal response) and going dizzy. 

The' school boy fainting trick' is to hyperventilate in a crouched position, hold your breath and squeeze the chest ( A Valsalva's manoeuvre ), stand up, and you will passout!  Years ago when I read this in a physiology book I tried it. Thought this is a load of rubbish... and woke up with a splitting headache on the floor having missed the cushions I put down to break my fall!   All of the above tricks reduce venous return and the heart just cannot increase its rate sufficiently quickly to sustain blood pressure. Clearly having a pacemaker for a sick sinus adds a worsening factor to the above. Nausea is part of the vaso-vagal response as the vagus nerve innervates the stomach and heart, amongst other things ( Vagus, comes from the same ?Latin route as vagrant- meaning one that wanders ... in this case around the body).


by happy2bealive - 2020-05-26 09:54:36

Both Selwyn and  IAN MC...great feedback. 

@IAN - yes my peripherals (hands for sure) get chalk white when I experience an episode. Yesterday was no different. So that makes sense. No sure why this hasn't happened within the year but I'll definitely do your hydration + salt strategy.

@Selwyn- what you describe makes perfect sense. I'll skip trying the school boys trick and take your word for it :) Seems that it was the perfect storm both days.

Thx for the feedback!

Saw the cardiologist

by happy2bealive - 2020-05-28 15:45:02

So after blood tests came back with nothing special (they thought maybe anemia or even low blood sugar), they raised my resting rate from 60 to 70. This has made me feel much better (seems a little high and I may go back to get it lowered to 65 or so). 

Pretty confused as to why this just happened out of the blue, but I guess as long as I'm not dizzy and nauseous all the time I'll take it.

Same issues here....

by bobjohnson - 2020-06-28 01:18:59

Hey everyone.  First post for me.  Had my pacemake installed on March 29th, turned 52 on April 14th.  Was having numerous syncopse episodes after coming back from Philippines to LA in December with a viral infection and started passing out and vomiting. I have had faintness when exercising before, but now with the pacemaker, I'm still having the symptoms you describe here OP. Same thing the docs in LA thought sudden drop in BP.  It was not until I got back ot Vancouver they put me on a two week heart monitor and said my heart was stopping several times a day for up to 4 seconds at a time. 

Now I can do pushups again (I'm pretty fit) but I will have episodes where I get up and not right away, but a minute or two later I'll feel faint, tinglibng like lsos of circulation, mildly nauesous and weak. My PM min was set to 60, but was working 100% of the time, so they reduced it to 50. But sometimes, after exercise, it is farily low then gets hard and fast and I get that sensation of weakness and it takes about 30 minutes to recover. 

I drink a fair amount of water, no shortage of salt and I eat lots of red meat, so should be no iron problems. Cool to have this resource to share info. Hope you get better OP and intersted to hear what they find out.

Very similar

by Mh85 - 2020-06-28 20:02:39


Very similar here, it usually happens to me while

working out. I especially can't seem to tolerate yoga, the up and downs make so feel so nauseous and dizzy. I started fainting at 5 and got my first pacemaker at 19. I had a tilt table test done at 18 - it's not as bad as it all sounds :) I'm about to go in for my third pacemaker and will have both leads replaced as well, I'm 34 now. My diagnosis is vasovagal syncope. It's something I've just gotten used to as I'm fairly active and like to work out and run and have three small kids. I know if I'm dehydrated it happens more frequently and especially if my electrolytes are off. Keeping that balance of water and electrolytes seems to be key for my body.


hope you're feeling better!

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Hi, I am 47 and have had a pacemaker for 7 months and I’m doing great with it.