Dizziness

Questions To Help You Decide Whether or not You Should Seek Medical Help for a Dizzy

• Dizziness is a common description used for many different feelings. Some people may refer to it as giddiness or a "dizzy spell."
• Vertigo is similar to, but not the same as, dizziness, and it describes a spinning sensation of a person's surroundings, usually caused by head movement or positioning. Several diseases of the balance organs of the inner ear can cause vertigo, or it may be a symptom of a tumor or stroke.
• Causes of dizziness include:
  • heart diseases (heart attack),
  • blood pressure problems,
  • brain diseases or conditions (stroke, dementia, and migraines),
  • medications (blood pressure and pain medications, and antibiotics),
  • metabolic disorders (hypoglycemia and dehydration),
  • aging,
  • psychiatric conditions (anxiety, stress, and depression)
  • pregnancy, and
  • other illnesses (allergies, sinus infections.
• Signs and symptoms of dizziness include:
  • lightheadedness,
  • feeling faint or passing out,
  • spinning, whirling, or motion (either of themselves or of the surroundings),
  • weakness,
  • tiredness,
  • confusion,
  • feeling off balance,
  • headache or head pressure,
  • chest pain or tightness,
  • nausea, and
  • vomiting.
• Dizziness may be a symptom of a condition or disease that is something more dangerous and should always be discussed with a doctor.
• Medical treatment for dizziness depends on the underlying cause and should be evaluated by a medical professional.
• The prognosis for dizziness depends on the cause. Most causes of dizziness are harmless, and the problem goes away on its own. Sometimes dizziness will be the only symptom of serious disease, the course of which may be life-threatening or easily treatable.

Dizziness is a common symptom during pregnancy. One of the reasons women feel dizziness during pregnancy is due to rising hormones that cause blood vessels to dilate, which increases blood flow to the baby but also can result in lower blood pressure and temporary dizziness.

Other causes of dizziness during pregnancy include low blood sugar levels as the body's metabolism changes. Women who are anemic or who have varicose veins may experience dizziness more often.

Dizziness can occur in any trimester. It is most common in the first trimester, but during the second trimester, the expanding uterus puts pressure on blood vessels and can cause dizziness. In the third trimester, when you lie on your back the weight of the baby presses on your vena cava (a large vein that carries blood from your lower body to your heart) which can result in dizziness.

Contact your doctor if you experience dizziness during pregnancy, especially if the dizziness is constant or persistent, or if it is accompanied by pain in your abdomen or vaginal bleeding, blurred vision, headaches, or heart palpitations.

Dizziness may be attributed to a wide variety of causes. Sometimes doctors find no specific diagnosis for the affected individual, but some causes of dizziness are dangerous. Some causes of dizziness are listed.

• Heart attack
• Arrhythmia (irregular heart rhythms)
• Heart rate that is too fast or slow
• Weakened, aged, or diseased heart muscle (cardiomyopathy), toxins, or drugs that affect the rate or force of the contractions of the heart
• Extremely high blood pressure
• Low blood pressure, which can have multiple causes including heart diseases, bleeding disorders, anemia, and adverse reactions to medications

• Stroke
• Tumor
• Headaches
• Migraines
• Loss or decrease of blood supply to the brain, such as fainting (syncope or vasovagal syncope)
• Dementia or confusion

Almost all medications list dizziness as a possible side effect, but it is more common with some types of medicines:

• Blood pressure medications
• Diuretics
• Sedatives
• Tranquilizers
• Antidepressants
• Pain relievers
• Some antibiotics

• Hypoxia (low blood oxygen)
• Low blood sugar (hypoglycemia including an insulin reaction
• Dehydration

• Reduced capacity for exercise or activity, weakness, and deconditioning
• Reduced ability for blood circulation to compensate for quickly assuming an upright position (orthostatic hypotension)
• Hardening of the arteries (arteriosclerosis)
• Neuropathy (a progressive dysfunction of the nerves that is caused by different illnesses, especially diabetes)
• Menopause
• Poor eyesight and coordination
• Dementia
• Hearing loss or ringing in the ears (tinnitus)

• Depression
• Anxiety disorder 
• Panic disorder
• Hyperventilation from breathing too fast or too deeply, usually from anxiety or metabolic disorders
• Somatization (the conversion of a mental illness, such as anxiety or depression, into physical symptoms)

• Internal bleeding or hemorrhage
• Anemia (low red blood cell count)
• Prolonged bed rest, causing weakness and loss of ability to compensate for assuming an upright position infections
• Endocrine diseases in which hormone-producing organs such as the thyroid, adrenal glands, and pituitary gland affect hydration, salt balance, and function of other organs
• Allergies (may cause wheezing and low blood pressure or trigger sinusitis, which can result in dizziness)
• Postprandial hypotension (low blood pressure after eating)

With dizziness, the person may feel faint, near passing out, weak, nauseated, confused, tired, clumsy, off balance, or any combination of these. The individual may perceive a sensation of movement, spinning, rocking, or whirling, of themselves or the room (possible vertigo).

Often, dizziness is accompanied by other symptoms such as:

• Faintness ("lightheadedness") or actual fainting
• Weakness or tiredness
• Confusion
• Feeling off balance
• Headache or head pressure
• Chest pain or tightness
• Nausea or vomiting

Dangerous, life-threatening illness may start only with dizziness. Call a doctor if any of the following occur:

• Any severe first-time or new instances of dizziness
• Dizziness without a clear or certain cause, or sudden dizziness
• Any change in an established pattern of dizziness
• Worsening or new symptoms
• Dizziness after taking newly prescribed medications, or recent changes in previous prescriptions

Call 911, or go to an emergency department if dizziness is associated with the following symptoms:

• Chest pain
• Palpitations
• Shortness of breath
• History of heart disease
• Loss of consciousness, fainting, or nearly fainting
• Facial droop
• Slurred speech
• Weakness on one side of the body
• Inability to walk straight
• Fever or pale skin

Rapid evaluation and treatment may be necessary if doctors suspect a serious cause of dizziness.

The doctor will ask detailed questions and take a history to define the type of dizzy feeling. The patient's description of the dizzy feeling may be the most important detail. The patient will be given a detailed physical exam to further define likely causes.

Tests ordered will be based on the diseases suggested by the patient's history and results of the physical exam.

• In the emergency department, the patient may be placed on a heart monitor, electrocardiogram (ECG) may be performed, and blood studies may be ordered. Sometimes specialized tests such as a CT scan or a cardiac stress test may be ordered.
• Rarely, the patient may have to have surgery to treat internal bleeding or hemorrhage, if this is the cause for the symptoms.
• The patient may be hospitalized or sent to a physician specialist depending on the possible causes.
• The doctor may find no specific cause for the dizziness, but will attempt to exclude other serious diseases.

Treatment varies widely and depends on the cause of the patient's dizziness. Dizziness often is a symptom of another medical condition. Treating the underlying illness or condition can improve the symptoms of dizziness.

Some common treatments for conditions that cause dizziness include:

• If a serious medical problem is found to be the cause of a person's dizziness, such as a heart attack or stroke, an emergency blood transfusion, intervention, or surgery may be needed.
• IV fluids may be given to treat dehydration.
• The patient may receive medications to control fever or treat infection.
• The patient may be given oxygen if they are short of breath or hyperventilating.
• If blood tests reveal abnormal blood chemistry (electrolyte levels), this will be corrected.
• Medications such as meclizine (Antivert) or benzodiazepines (such as diazepam [Valium], lorazepam [Ativan]) are used to control the spinning feeling associated with dizziness, when vertigo is a possible cause.

If a person is feeling dizzy, it may be a symptom of a condition or disease that is something more dangerous and should always be discussed with a doctor to determine the possible reasons for the dizziness. Medical treatment for dizziness depends on the cause and should be evaluated by a medical professional.

The following home remedies may be recommended for mild cases of dizziness:

• Get plenty to drink, have regular meals, and get plenty of rest.
• Lie down.
• Stand up slowly, as this may help with dizziness associated with position changes.
• Make your home safe for a chronically dizzy person (banisters, a walker or cane, and tub mats are safety measures that may help avoid injury to the patient).
• Secure rugs and carpeting to avoid falls (a doctor can recommend resources for a professional home-safety consultant visit).

• Most causes of dizziness are harmless, and the problem goes away on its own. Sometimes dizziness will be the only symptom of serious disease, the course of which may be life-threatening or easily treatable.
• Sometimes the cause of dizziness may not be immediately found. The affected individual may need the services of a specialist, or very detailed specialized testing to uncover the cause and develop a treatment plan for the person's dizziness.
• Timely and careful evaluation of dizziness offers the best outcome, whatever the cause.