Dizziness

Dizziness – Symptoms, Causes & When to Seek Help

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What is dizziness?

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Dizziness is a broad term people use to describe a range of sensations — from feeling light-headed or unsteady to a sense that the room is moving. Occasional dizziness is common, but recurrent or unexplained episodes can signal a problem with your heart, blood pressure, or circulation and should be assessed by a specialist.

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As a cardiologist, I regularly see patients with dizziness caused by arrhythmias, low blood pressure, and other cardiovascular conditions. A careful assessment is essential to identify the underlying cause.

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Common symptoms associated with dizziness

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People experiencing dizziness may notice one or more of the following:

• A sensation of spinning or unsteadiness

• Light-headedness or feeling faint

• Balance difficulties

• A heavy, foggy or “floaty” feeling

• Brief blackouts or “near-fainting” spells

• Palpitations or irregular heartbeat during episodes

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When dizziness is an emergency

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Seek urgent medical help if dizziness is sudden, severe, or accompanied by:

• Intense headache or sudden visual changes

• Persistent nausea or vomiting

• Difficulty walking or speaking

• Chest discomfort or shortness of breath

• Rapid or irregular heartbeat

• Weakness, numbness, or collapse

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These symptoms may indicate a stroke, heart rhythm disorder, or another serious condition.

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What causes dizziness?

Dizziness can arise from many different systems within the body. Causes related to the heart and circulation are particularly important because they may require treatment.

Cardiac and circulatory causes include:

• Low blood pressure (including postural/orthostatic hypotension)

• Arrhythmias, such as atrial fibrillation or slow heart rhythms

• Intermittent pauses in the heart’s rhythm

• Reduced heart pumping function (cardiomyopathy)

• Narrowing of the heart valves

• Dehydration or low blood volume

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Other common causes include:

• Inner ear or balance disorders

• Migraine

• Infections

• Medication side effects

• Low blood sugar

• Anaemia

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A detailed assessment helps determine whether your dizziness is benign or linked to a cardiac condition requiring treatment.

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How dizziness is diagnosed

During your consultation, I will take a detailed clinical history and perform an examination focused on your heart, circulation, and neurological system.

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Depending on your symptoms, investigations may include:

• ECG (electrocardiogram) – checks heart rhythm

• Ambulatory ECG monitoring (24–72 hrs) – identifies intermittent rhythm problems

• Echocardiogram – assesses heart structure and function

• Ambulatory blood pressure monitoring – evaluates blood pressure patterns

• Exercise stress testing – determines whether exertion triggers symptoms

• Cardiac MRI scan – detailed imaging if needed

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These tests help pinpoint the cause and guide the most appropriate treatment.

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Treatment for dizziness

Your treatment plan will be tailored to the specific cause of your symptoms. This may include:

• Adjusting medications

• Managing dehydration or low blood pressure

• Treating arrhythmias (e.g., with medication, pacemaker, or catheter ablation)

• Managing AF or other rhythm disorders

• Addressing structural heart problems

• Lifestyle adjustments to reduce triggers

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My priority is to provide clear answers, reduce uncertainty, and help you regain confidence in everyday activities.

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Preventing dizziness

Although not all dizziness is preventable, certain steps can help reduce episodes:

• Staying hydrated

• Avoiding long gaps between meals

• Standing up gradually

• Reviewing medications if dizziness is a side effect

• Managing blood pressure and cardiovascular risk factors

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The most important step is understanding why you feel dizzy — once the cause is identified, many people experience significant improvement.

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When to seek specialist assessment

If you experience recurrent, unexplained, or worsening dizziness, or you suspect it may be related to your heart rhythm or blood pressure, specialist evaluation can provide clarity and effective treatment options.