1. Balance Disorders Slideshow
2. Take the Vertigo Quiz
3. Tinnitus Slideshow: Why Are My Ears Ringing?

Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• Introduction to dizziness (feeling dizzy)
• What are some common causes of dizziness?
• Low blood pressure
• Postural or orthostatic hypotension
• High blood pressure
• Diabetes
• Endocrine diseases
• Hyperventilation
• Heart conditions
• Vasovagal syncope
• Dizziness and vertigo
• What are the symptoms experienced when a person feels dizzy?
• When should I call the doctor for dizziness?
• How is dizziness diagnosed?
• How is dizziness/vertigo diagnosed?
• How is dizziness treated?
• Dizziness At A Glance
• Patient Comments: Dizziness - Diagnosis
• Patient Comments: Dizziness - Causes
• Patient Comments: Dizziness - Standing Up
• Patient Comments: Dizziness - Treatment
• Dizziness (Dizzy) Index

The diagnosis of dizziness begins with the health care practitioner evaluating whether the complaint of dizziness refers to lightheadedness or vertigo. Further direction continues once this distinction is made.

The key to the diagnosis of dizziness is a thorough history and physical examination. Often the diagnosis is made by listening to the patient's story. The health care practitioner may ask about triggers that cause and relieve the symptoms of dizziness, such as:

• "Is it related to changing positions quickly?" and
• "Does it resolve on its own or does the patient have to do something, like lie down to make it better?"

A review of systems is a series of questions that review the patient's body functions. Questions may be asked about associated symptoms including fever, vomiting, diarrhea, chest pain, shortness of breath, palpitations, or abnormal bleeding. The past medical history may be reviewed, and this includes reviewing  medications the patient is currently taking.

A thorough physical examination will likely be done, this may include:

Vital signs: Taking the patient's blood pressure and pulse rate lying down and standing (called orthostatic or postural vital signs) often will indicate the fluid status of the body. In patients who are dehydrated or bleeding, the vital signs may rise on changing position. However, patients taking medications such as beta blockers will not generate in increased pulse rate.

Tailored physical examination: Often, the physical examination is tailored to the patient based upon the information provided in the patient's medical history. For example, a woman with a heavy menstrual period may need a pelvic examination, or a patient with cough and shortness of breath may need a closer examination of the heart and lungs.

Imaging studies and blood tests: The need for imaging studies and/or and blood tests will depend on the concerns the health care practitioner and patient have in regard to the cause of the dizziness. Common tests that may be ordered include:

• complete blood count (CBC) to screen for anemia or infection,
  
  
• evaluation of electrolytes,
  
  
• blood sugar tests,
  
  
• kidney function tests, and
  
  
• thyroid tests.

X-rays, CT scans, and MRI may be indicated depending upon the patient's needs.