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?
Older adults who are experiencing dizziness or lightheadedness upon standing should be tested for orthostatic hypotension.
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. This is because a carotid occlusion can cause dizziness with standing as well.
These assessments are typically a standard part of a work-up for a dizzy patient.
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.
Disclaimer
This blog is provided for informational 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.
my husband is suffering from continuous dizziness for over 50 days…only the degree of dizziness changes…it seems to be worse in the early morning hours…the ENT insists on continuing vestibular therapy…this does not seem right…I don’t know what to pursue for him…
Hi Gay,
Dizziness that is worse in the morning is common symptom of BPPV. Here is a link to an article on that topic, where I mention that common complaint.
Research is clear that vestibular PT is the best place to start for people with dizziness.
It is good that the ENT is even familiar with vestibular therapy as an option. Many doctors are not.
I hope you are able to find a local vestibular PT who is experienced to help.
You can use this article to search for local vestibular physical therapist.
Best wishes!
6 days after heart attack I have developed lightheadednes when in motion and palpitation when sitting or lying
Hi Joseph,
I’m sorry to hear this! I’m glad you survived the heart attack.
Of course, you should follow up with your primary doctor and cardiologist after the heart attack. They may be able to help.
You may also want to seek evaluation with a vertigo doctor, which you can search for using this article.
You can document your symptoms using the questions I ask in this article, to share with all your doctors.
Have recurrent attack of vertigo since a couple months now. They are short lived (10-15 seconds), untriggers (around 1 maybe 2 times a day). After the main vertigo, I find it difficult to walk (like am drunk, very dis-balanced) for a couple minutes (usually up to 20-25) then all is fine..until the next attack! Dix and roll tests are negative (do not produce vertigo). Had an ECG which is normal as well as an MRI (also normal). Pretty confusing.
We’re of same symptoms and I don’t know what my disease is… I’m thinking of undergoing ECG or 2d echo
I have very intense episodes of dizziness that last less 5 seconds. I do have pvcs but no heart disease. My doctor doesn’t seem worried but I sure am. It makes me feel like I am
Going to fall down when it happens. Thoughts?
Hi Kate,
If you have not already seen an Otoneurologist, that might be helpful.
Fear of falling is important to address because research shows it can alter how you walk and increase your risk of falls.
You can also ask for a referral to vestibular PT.
Hopefully you already had a cardiologist consult based on what you shared about the pvc’s, but if not that may be appropriate also.
Best wishes!