Dizziness when standing can be harmless — or it can signal your heart or arteries aren't delivering enough blood to your brain. Both an echocardiogram and a carotid ultrasound can help sort it out, and we can do either at your home this week.
Dizziness when standing can be harmless — or it can signal your heart or arteries aren't delivering enough blood to your brain. Both an echocardiogram and a carotid ultrasound can help sort it out, and we can do either at your home this week. No referral needed. We come to you. Results in 24–48 hours.
Important: If dizziness is accompanied by sudden severe headache, difficulty speaking, weakness on one side, vision changes, or you faint and cannot be roused, call 911 immediately. These can be signs of stroke.
When you change from lying or sitting to standing, gravity pools blood in your legs and lower body. Normally, your cardiovascular system compensates within a second or two — your heart speeds up slightly and your blood vessels constrict to maintain pressure to the brain. In orthostatic hypotension, this compensation is too slow or too weak, causing a brief drop in blood pressure. The brain momentarily under-perfuses, and you feel lightheaded or dizzy. Mild cases are often related to dehydration, heat, or medications (particularly blood pressure drugs). Frequent or severe episodes warrant investigation.
When the heart's pumping function is compromised — due to weakened heart muscle, valve abnormalities, or other structural issues — cardiac output falls. Less blood reaches the brain with each beat, and the drop becomes more pronounced with position changes. An echocardiogram directly measures ejection fraction (how efficiently the heart pumps), evaluates all four chambers, and assesses every valve. If a cardiac contributor is present, the echo will identify it — giving you and your doctor actionable information rather than a vague explanation.
The carotid arteries deliver the majority of blood to the brain. When these arteries are narrowed by plaque, the brain may receive adequate flow under normal conditions — but when demand increases (as it does when you stand and the heart must rapidly compensate), even moderate stenosis can produce symptoms. Dizziness on standing, combined with risk factors such as high blood pressure, high cholesterol, smoking history, or age, warrants a carotid duplex ultrasound. The test measures blood flow velocity and can identify narrowing before it causes a TIA or stroke.
Dehydration reduces total blood volume, making it easier for blood pressure to drop on standing. Diuretics, blood pressure medications, and some antidepressants are common culprits for postural dizziness. These causes are not detectable on ultrasound — but ruling out cardiac and vascular contributors first narrows down the picture significantly, and your primary care provider can evaluate medication-related causes alongside ultrasound results.
Evaluates heart pump function, ejection fraction, chamber size, and valve integrity. Priority if you have cardiac risk factors, palpitations, or shortness of breath alongside dizziness.
About echocardiograms →Evaluates blood flow to the brain, plaque buildup, and carotid stenosis. Priority if you have high blood pressure, high cholesterol, smoking history, or strong family history of stroke.
About carotid duplex →Both studies can be performed in the same visit if warranted. Emanuel Papadakis, RDCS, RVT, holds dual credentials in both cardiac and vascular sonography — meaning one sonographer, one home visit, and a complete cardiovascular picture.
Both scans are non-invasive and performed at your home:
The most common cause is orthostatic hypotension — a temporary blood pressure drop when you change position. This can be benign, related to dehydration or medication, or it can reflect reduced cardiac output or carotid artery narrowing. An echocardiogram evaluates heart pump function; a carotid duplex evaluates blood flow to the brain.
Seek evaluation if it is frequent or worsening, you feel near-fainting rather than brief lightheadedness, or you have cardiac risk factors. Sudden severe headache, speech difficulty, or one-sided weakness alongside dizziness — call 911 immediately.
Yes — an echocardiogram can identify reduced cardiac output, valve problems, and structural issues. A carotid duplex can identify carotid narrowing and reduced brain blood flow. Together they address the two most significant cardiovascular contributors to postural dizziness.
If you have cardiac symptoms (palpitations, shortness of breath), the echo is the priority at $397. If you have vascular risk factors (high blood pressure, high cholesterol, smoking, family history of stroke), the carotid duplex is $397. Both can be done in one visit. No referral required.
Southern Maine · Mobile Service
Book your echocardiogram or carotid duplex this week. We come to you — no referral, no waiting room. Written results in 24–48 hours.
Book Your Scan This WeekEcho $397 · Carotid $397 · No Referral · Southern Maine · Evening & Weekend Availability
Package pricing available when combining multiple scans.