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Awesome content Dr. One of the best medical yt channel out there

Thanks for the suggestion. For the most part, I try to keep my videos within my usual scope of practice and/or expertise. Unfortunately, anything more than the most basic of echo interpretation falls outside both. I can imagine collaborating with someone in the future on it, but that would be a long-range goal.

First, regarding your ramipril, I can't offer specific, individualized medical advice here, and I recommend speaking directly with the clinician who described the medication about your dizziness. However, your second question is interesting - I'll rephrase it as "Why do we get symptomatic from low blood pressure?". After all, if vasodilation leads to decreased afterload for the heart, that increases cardiac output, which should improve the delivery of oxygen to peripheral tissues. Why is there a threshold vascular resistance below which this is a bad thing? It is surprisingly difficult to find a clear answer to this question. At least part of the explanation is that diffuse vasodilation, beyond a threshold degree, results in the resistance within vascular beds falling outside of the range in which they can be individually regulated, such that the body loses the ability to control where blood is directed. When this happens, blood (and oxygen) can no longer be preferentially shunted towards organs with relatively high oxygen need (e.g. the brain). If anyone knows of additional mechanisms at work here, please reply - I'd love to have a more complete understanding of this myself.

@@StrongMed sir may be due to peripheral pooling of blood which leads to decrease preload