Abstract
I want to suggest the use of systolic blood pressure in the approach to patients who complain of dizziness. I propose that we should place such patients into three group when we first see them.
The first group is patients with vertigo, in most of whom the symptoms of dizziness are due to CNS diseases or internal ear diseases. Although the problem in 90% of this group is caused by an internal ear disease, CNS diseases must be ruled out as quickly as possible, especially in patients with a high systolic blood pressure.
The second group consists of patients with pre-syncope. Although the problem in most of this group is neurally mediated, cardiovascular and hypovolemic problems must be ruled out as quickly as possible, especially in patients with a low systolic blood pressure.
The third group comprises patients with ill-defined dizziness, in whose case we had better investigate all causes, including the diseases associated with vertigo and pre-syncope.
