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Why is it that after driving I feel as though I am going to pass out?

I am a 40y/o male and work in the EMS field. One year ago I had a cath done to show that I had a 97% blockage in the LAD and 95% in the RCA. Both have been stented. It is becoming more and more of a concern. It doesnt happen right as I step out. Its when I start moving the pt that is on a stretcher that I begin to feel very light headed and drifting to the right. I have had to stop for a minute or 2 to get my bearings. I take two different beta blockers. I am also diabetic but sugars are greatly controled. In the battle to fight the diabeties I have lost in the last year almost 40lbs. I have been to the doctor and he only says to take a following of my bp. just wanted to get another possible answer
There are actually several potential causes for your presyncope episodes, all of which you should discuss with your doctor! The first thing that you should check is your blood pressure and heart rate while exerting yourself compared to when you are resting. It takes your body a stronger sympathetic response (almost falling) in order to overcome the high beta blockade in the heart. This is similar to post operative patients with sepsis but their heart rates are "normal" because they are on a beta blocker. If your blood pressure and heart rate fail to "catch up" while you exercise then it points to your blood pressure medication being too high. In fact, have you been taking these medications for a long time? A large dose of beta blocker will prevent your heart from responding appropriately to physiologic demand i.e. exercising. You should discuss changing blood pressure medication or lowering the dosage if appropriate with your doctor. The other possibilities include aortic stenosis, cardiac arrhythmia, dehydration, and adrenal insufficiency. You would benefit from a thorough work up including investigating the above issues as well as getting an EKG to look for any arrhythmia, perhaps an echocardiogram to make sure that you blood flow through the valves are normal without valvular stenosis, or prolapse. Depending on how long ago your stents have been and what antiplatelet medication, and what your EKG/echo show you may need another cardiac angiogram.
This answer is for general informational purposes only and is not a substitute for professional medical advice.
If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment. Medical professionals who provide responses to health-related questions are intended third party beneficiaries with certain rights under Zocdoc’s Terms of Service.

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