OBJECTIVES: To assess how frequently cardiovascular dizziness is vertigo. Recent studies suggest providers do not consider cardiovascular causes when a patient reports true vertigo (spinning/motion) as opposed to presyncope (impending faint). It is known that cardiovascular disease causes dizziness, but unknown how often such dizziness is vertiginous, as opposed to presyncopal. DATA SOURCES: Systematic review of observational studies was made: Search--electronic (MEDLINE, EMBASE) and manual (references of eligible articles) search for English-language studies (1972-2007). REVIEW METHODS: Inclusions Studies of >or=5 patients with confirmed cardiovascular causes for dizziness and reporting a proportion with vertigo were included. Two independent reviewers selected studies for inclusion, with differences adjudicated by a third. Study characteristics and dizziness-type proportions were abstracted. Studies were rated on methodology and quality of dizziness definitions. Differences were resolved by consensus. RESULTS: We identified 1,506 citations, examined 125 full manuscripts, and included 5 studies. Principal reasons for exclusion were: abstracts--lack of original data, no cardiovascular diagnosis, or confounding exposure/disease (74%); manuscripts--failure to distinguish vertigo from other dizziness types (78%). In the three studies not using vertigo as an entry criterion (representing 1,659 patients with myocardial infarction, orthostatic hypotension, or syncope), vertigo was present in 63% (95% CI 57-69%) of cardiovascular patients with dizziness and the only dizziness type in 37% (95% CI 31-43%). Limitations include modest study quality and non-uniform definitions for vertigo. CONCLUSIONS: Published data suggest that dizziness from primary cardiovascular disease may often be vertigo. Future research should assess prospectively whether dizziness type is a meaningful predictor for or against a cardiovascular diagnosis.
OBJECTIVES: To assess how frequently cardiovascular dizziness is vertigo. Recent studies suggest providers do not consider cardiovascular causes when a patient reports true vertigo (spinning/motion) as opposed to presyncope (impending faint). It is known that cardiovascular disease causes dizziness, but unknown how often such dizziness is vertiginous, as opposed to presyncopal. DATA SOURCES: Systematic review of observational studies was made: Search--electronic (MEDLINE, EMBASE) and manual (references of eligible articles) search for English-language studies (1972-2007). REVIEW METHODS: Inclusions Studies of >or=5 patients with confirmed cardiovascular causes for dizziness and reporting a proportion with vertigo were included. Two independent reviewers selected studies for inclusion, with differences adjudicated by a third. Study characteristics and dizziness-type proportions were abstracted. Studies were rated on methodology and quality of dizziness definitions. Differences were resolved by consensus. RESULTS: We identified 1,506 citations, examined 125 full manuscripts, and included 5 studies. Principal reasons for exclusion were: abstracts--lack of original data, no cardiovascular diagnosis, or confounding exposure/disease (74%); manuscripts--failure to distinguish vertigo from other dizziness types (78%). In the three studies not using vertigo as an entry criterion (representing 1,659 patients with myocardial infarction, orthostatic hypotension, or syncope), vertigo was present in 63% (95% CI 57-69%) of cardiovascular patients with dizziness and the only dizziness type in 37% (95% CI 31-43%). Limitations include modest study quality and non-uniform definitions for vertigo. CONCLUSIONS: Published data suggest that dizziness from primary cardiovascular disease may often be vertigo. Future research should assess prospectively whether dizziness type is a meaningful predictor for or against a cardiovascular diagnosis.
Authors: Victoria A Stanton; Yu-Hsiang Hsieh; Carlos A Camargo; Jonathan A Edlow; Paris B Lovett; Paris Lovett; Joshua N Goldstein; Stephanie Abbuhl; Michelle Lin; Arjun Chanmugam; Richard E Rothman; David E Newman-Toker Journal: Mayo Clin Proc Date: 2007-11 Impact factor: 7.616
Authors: P A Low; T L Opfer-Gehrking; B R McPhee; R D Fealey; E E Benarroch; C L Willner; G A Suarez; C J Proper; J A Felten; C A Huck Journal: Mayo Clin Proc Date: 1995-07 Impact factor: 7.616
Authors: Kevin A Kerber; James F Burke; Devin L Brown; William J Meurer; Melinda A Smith; Lynda D Lisabeth; Lewis B Morgenstern; Darin B Zahuranec Journal: Emerg Med J Date: 2011-01-18 Impact factor: 2.740
Authors: Ali S Saber Tehrani; Jorge C Kattah; Kevin A Kerber; Daniel R Gold; David S Zee; Victor C Urrutia; David E Newman-Toker Journal: Stroke Date: 2018-02-19 Impact factor: 7.914