# Head Rush



## lemonlime (Sep 24, 2003)

Anyone else get a head rush often? I usually get them after longer, higher intensity rides. If I'm laying on the couch, I get up for some reason and get them so bad sometimes it buckles my knees. This will last for a few hours and then they seem to go away.

Lately, though, they've been happening more often and not necessarily after a ride. It doesn't really worry me too much, I'm just wondering about the reasons for them.


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## Dwayne Barry (Feb 16, 2003)

lemonlime said:


> It doesn't really worry me too much, I'm just wondering about the reasons for them.


It is common and is due to an acute low blood pressure response following the exercise. So you stand up and blood pressure isn't sufficient to keep enough blood going to your brain and you start to pass out. It's called not surprisingly, post-exercise hypotension. I thought I had read that it was controversial as to what actually causes it, but a quick Pubmed search produced at least one article flatly stating it was due to continued vasodilation to the previously working muscles.


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## Spunout (Aug 12, 2002)

It means you are in good shape (most of the time).


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## Dwayne Barry (Feb 16, 2003)

Spunout said:


> It means you are in good shape (most of the time).


I'm not sure about that. The general lowering of blood pressure due to aerobic exercise yes, but the acute post-exercise response I'm not so sure. Seems like when I'm in better shape, it doesn't happen as readily to me.

Not sure if anyone has looked at it or not, but if I had to bet, I'd put my money on more fit people being less susceptable to it than less fit people. If anyone has examined it they would have probably compared trained vs. untrained folks.


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## lunky (Jan 6, 2006)

Yes, I too have that issue. Twice getting out of bed in the morning I actually fainted very briefly. Then after doing an hour spinning at the Y and another hour on the staionary and worked very hard. I came home, rested on the couch. I got up quick, stumbled to a bar stool and completely fainted. I woke up still holding the bar stool (on the floor on top of me) and seeing my wife, son and two of his friends looking down on me.

Otherwise I am fit, feel good. Im 5'11", 160 lbs. Had my V02 tested at 48. I can easily run my heart rate to 170 while exercising. Resting heart rate is about 52, Triglycerides =45, Totalcholesterol =165. Im 46 years old. 112/72 blood pressure at last physical exam.

My point is Im in pretty good shape but find it troubling I am having fainting issues and head rushes often. Im still concerned there may be something wrong with me that I do not
know about. So was glad to see your post which makes me think it is just low blood pressure after exercising. I have also read that President Bush had similiar issues and I know his resting heart rate is in the forties.

Im curious your size, phsical condition and etc to see if we are similiar in that regard. Note after fairing a few times I learned the best thing is to get to the floor while your still able to (beats falling and have a bumpus noginous).


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## physasst (Oct 1, 2005)

*It*

could simply be post exercise hypotension, but it also could be hypoglycemia. Make sure that you are taking enough calories in while doing longer rides and/or intervals or harder workouts.


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## Oxtox (Aug 16, 2006)

*Maybe you just need some*

coffee...

Caffeine Attenuates Post-Exercise Hypotension


By Will Boggs, MD

NEW YORK (Reuters Health) Mar 10 - Caffeine infusion attenuates the early post-exercise hypotension that occasionally follows exercise testing, according to a report in the February American Journal of Hypertension.

Vasodilation mediated by adenosine is thought to contribute to this phenomenon, the researchers explain. "We used caffeine as an adenosine antagonist and found that early (10 minutes following peak exercise) post-exercise hypotension was eliminated, suggesting that this mechanism is important in early post-exercise hypotension," Dr. Catherine F. Notarius told Reuters Health.

Dr. Notarius and colleagues from the University of Toronto, Ontario, Canada investigated whether adenosine blockade with caffeine attenuates the blood pressure decrease during the immediate recovery period after graded bicycle exercise to peak effort. The team elected to study middle-aged (average age 51 years) subjects, because they are at higher cardiovascular risk, may have higher caffeine consumption, and are currently encouraged to exercise regularly to augment their blood pressure management. [

In this crossover study of 14 subjects, systolic blood pressure and mean arterial pressure were higher during submaximal exercise on the day of caffeine infusion, the researchers report, as were heart rate and plasma epinephrine at peak exercise.

During post-exercise recovery, mean arterial pressure and diastolic blood pressure fell significantly on the day of vehicle infusion, but not on the day of caffeine infusion. Systolic blood pressure, mean arterial pressure, and heart rate were all higher 10 minutes after exercise on the caffeine-infusion day than on the vehicle-infusion day, the report indicates.

Norepinephrine and epinephrine plasma concentrations after exercise did not differ significantly on the two study days, the authors note.

"The present findings would suggest that any assessment of cardiovascular risk that relies on measurements of postexercise blood pressure or heart rate may be compromised by prior caffeine intake," the investigators conclude. "In addition, the sensitivity of diagnostic tests such as dipyridamole stress imaging may also be reduced, in that the vasodilator response to accumulation of endogenous adenosine after dipyridamole infusion may be attenuated by relatively modest prior caffeine ingestion."

"These findings represent another example of the limitation of using dynamic blood pressures obtained in a clinical setting to evaluate the impact of non-pharmacological or pharmacological interventions on blood pressure," Dr. Notarius said.

"Note that our results are limited to 10 minutes post-exercise, when our measurement were made, and that the subjects were studied after a period of 72 hours of caffeine abstinence," Dr. Notarius added. "We do not know whether similar observations would have been made if habitual caffeine use had been continued."

Am J Hypertens 2006;19:184-188.


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## ru1-2cycle (Jan 7, 2006)

*Fainting issues.*



lunky said:


> Yes, I too have that issue. Twice getting out of bed in the morning I actually fainted very briefly. Then after doing an hour spinning at the Y and another hour on the staionary and worked very hard. I came home, rested on the couch. I got up quick, stumbled to a bar stool and completely fainted. I woke up still holding the bar stool (on the floor on top of me) and seeing my wife, son and two of his friends looking down on me.
> 
> Otherwise I am fit, feel good. Im 5'11", 160 lbs. Had my V02 tested at 48. I can easily run my heart rate to 170 while exercising. Resting heart rate is about 52, Triglycerides =45, Totalcholesterol =165. Im 46 years old. 112/72 blood pressure at last physical exam.
> 
> ...


Get a 12 leads EKG by a qualified healthcare provider, a physical exam also, by expert auscultation of your CV system, to ascertain for abnormal findings like a heart murmur or stenosis (narrowing) to your jugulars or femorals. Family history of similar problems or early heart disease, stroke also are important details to inquire about. If any doubts/concerns about the assessment findings, then a chest x-ray 2 views and perhaps a 2D echocardiogram (sonogram of your heart, visualizing with sound waves your heart valves, wall motion, chamber size, etc,) would also be appropriate, along with the expert second opinion of a qualified cardiologist. When I perform a sports physical, I pay particular attention to screening for cardiomyopathy (basically an enlarged heart), often involved in fainting spells, due to rate or pump compromise or failure. Yes, it can have signs and symptoms ranging from the dramatic chest pain, shortness of breath, to just plain recurrent dizziness or fatigue.


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## physasst (Oct 1, 2005)

*Yep*



ru1-2cycle said:


> Get a 12 leads EKG by a qualified healthcare provider, a physical exam also, by expert auscultation of your CV system, to ascertain for abnormal findings like a heart murmur or stenosis (narrowing) to your jugulars or femorals. Family history of similar problems or early heart disease, stroke also are important details to inquire about. If any doubts/concerns about the assessment findings, then a chest x-ray 2 views and perhaps a 2D echocardiogram (sonogram of your heart, visualizing with sound waves your heart valves, wall motion, chamber size, etc,) would also be appropriate, along with the expert second opinion of a qualified cardiologist. When I perform a sports physical, I pay particular attention to screening for cardiomyopathy (basically an enlarged heart), often involved in fainting spells, due to rate or pump compromise or failure. Yes, it can have signs and symptoms ranging from the dramatic chest pain, shortness of breath, to just plain recurrent dizziness or fatigue.



+1 to this. My response above was to the OP regarding these symptoms after prolonged physical exertion. If you are getting these while resting, or upon awakening in the morning you need to see your MD. In addition to my colleagues comments above, you should also have your thyroid checked, and possibly a neurologic consult with MRI if warranted by history. Bottom line...if you are getting these symptoms AT ALL, you should see your doctor, but if they are occuring while resting, they are more worrisome. Most of the athletes I see in Sports Med clinic with these complaints are due to a postural post exercise hypotension and/or hypoglycemia. But you need to exclude the more sinister causes. So, see your Dr.


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## ru1-2cycle (Jan 7, 2006)

*Well said!*



physasst said:


> +1 to this. My response above was to the OP regarding these symptoms after prolonged physical exertion. If you are getting these while resting, or upon awakening in the morning you need to see your MD. In addition to my colleagues comments above, you should also have your thyroid checked, and possibly a neurologic consult with MRI if warranted by history. Bottom line...if you are getting these symptoms AT ALL, you should see your doctor, but if they are occuring while resting, they are more worrisome. Most of the athletes I see in Sports Med clinic with these complaints are due to a postural post exercise hypotension and/or hypoglycemia. But you need to exclude the more sinister causes. So, see your Dr.


I totally agree with you, and thanks for taking your precious free time to address the extra recommendations for this often overlook and seemingly harmless complaint among the fit and conditioned people we serve. As a fellow physician assistant I appreciated it very much.I have a basic medical philosophy: a slow resting heart rate (<60 beats per minute) could be a sign of a conditioned heart or a "sick heart" until proven otherwise, particularly if there are complaints of feeling dizzy, feeling like passing out or plainly passing out and waking up with your loved ones staring at you. It is a concerning and potentially serious sign/symptom, that needs to be fully assess/evaluated to minimize the chance of waking up and staring at your loved ones or yourself from above.


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