Cardiovascular Disease and Vertigo: Is there a Link?

People with underlying cardiovascular disease may experience symptoms of dizziness while sitting still and/or with activity.

Often times we find that there is a link between cardiovascular disease and vertigo.

This article contains more medical terminology than I typically include in my articles. If this content seems too complex…

You can simply consult a Cardiologist for assessment of any underlying causes of cardiovascular disease and vertigo.

Then you don’t need to read on.

How can Cardiovascular Disease Contribute to Vertigo?

The aging heart can develop rhythm disturbances, pumping insufficiency, or narrowing of the vessels within the heart.

Carotid occlusion, carotid sinus hypersensitivity, arrhythmias, cardiac syncope, moderate to severe atherosclerosis, heart failure, vertebra-basilar artery insufficiency, and small vessel ischemia are a few common examples of cardiovascular diagnoses that may contribute to dizziness in older adults.

Arrhythmias that contribute to dizziness include tachyarrhythmias, such as atrial fibrillation, as well as bradyarrhythmias.

These cardiovascular conditions are usually experienced as lightheadedness, which we would refer to as “dizziness.”

It is possible that we could see a link between cardiovascular disease and vertigo, which may be overlooked. Reduced blood flow to the inner ear vestibular system is the link between cardiovascular disease and vertigo.

This link may occur if the cardiac or vascular problem is affecting blood flow to the inner ear vestibular system.

Any reduction in blood flow to the inner ear can precede BPPV or the development of a vestibular hypofunction.

What about Lightheadedness with Standing?

People who are experiencing dizziness or lightheadedness upon standing should be tested for orthostatic hypotension (OH), which is one type of dysautonomia.

For more information about orthostatic hypotension, click here.

If orthostatic hypotension has been ruled out, these patients should also be screened for a possible carotid occlusion or another form of dysautonomia. This is because a carotid occlusion and other types of dysautonomia can cause dizziness with standing as well.

To learn what to do about dizziness upon standing, click here.

Electrolyte Imbalances can Contribute to Dizziness

Electrolyte imbalances, such as potassium levels that are too high (hyperkalemia) or too low (hypokalemia), can cause cardiac arrhythmias and may be a side effect of certain commonly prescribed medications.

Sodium, calcium and magnesium levels also affect cardiac contractility and relaxation.

Intervention by a healthcare provider is necessary to return electrolytes to acceptable levels and properly monitor prescribed medications that may cause electrolyte imbalances.

Healthcare providers can also further investigate a new onset of cardiac arrhythmia, positive carotid bruit, or signs of heart failure exacerbation.

Medical management may be necessary to reduce dizziness or vertigo related to these conditions.

Heart Palpitations

Another link found between cardiovascular disease and dizzy spells is that some people may have an occasional change in heart rhythm that they may experience as “palpitations.”

Heart palpitations may correlate directly with sporadic episodes of dizziness. This dizziness may be associated with a fluttering feeling in the chest.

An extra heart sound, called S4, is considered a normal part of aging.

Talk to your Doctor

If you are experiencing any dizziness or vertigo, your doctor may recommend a full work-up by a Cardiologist.

This may be an important step for you, due to the link between cardiovascular disease and vertigo.


This blog is provided for informational and educational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.

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