Cardiogenic vertigo: characteristics and proposed diagnostic criteria
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ORIGINAL COMMUNICATION
Cardiogenic vertigo: characteristics and proposed diagnostic criteria Hyun Ah Kim1 · Jinhee Ahn2 · Hyoung‑Seob Park3 · Suk‑Min Lee4 · Seo‑Young Choi4 · Eun Hye Oh5 · Jae‑Hwan Choi5 · Ji‑Soo Kim6,7 · Kwang‑Dong Choi4,8 Received: 9 June 2020 / Revised: 26 September 2020 / Accepted: 29 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Early identification of cardiogenic vertigo (CV) is necessary to prevent serious complications of cardiovascular diseases. However, the literature is limited to case reports without detailed clinical features or diagnostic criteria. The aim of this study was to define characteristics of CV and propose diagnostic criteria. This study included patients with CV diagnosed at Pusan National University and Keimyung University Hospitals. Demographic, clinical, laboratory, and treatment data were analyzed. Of 72 patients with clinically suspicious CV, 27 were finally included. The age ranged from 63 to 88 years (75.1 ± 7.2 years). Recurrent vertigo occurred without syncopal attacks in 52% [95% CI, 32–71], while it preceded (37% [19–58]) or followed (11% [2–29]) syncope. The patients with recurrent isolated vertigo had suffered from symptoms from 15 days to 5 years until final diagnosis (median 122 days). The vertigo lasted only for a few seconds (93% [76–99]) or a few minutes (7% [1–24]). Fourteen patients presented with spinning vertigo, and one of them showed spontaneous downbeat nystagmus during the attack. Accompanying symptoms including chest discomfort, palpitation, headache, arm twitching, and lightheadedness were found in 70% [50–86]. Between patients with and without syncope, there was no difference in clinical parameters and results of cardiac function tests. The most common cardiac abnormality during the attacks of vertigo was bradyarrhythmia (89% [71–98]). Cardiovascular diseases can develop recurrent isolated vertigo without or preceding syncope. Onset age, duration of vertigo, accompanying symptoms, and underlying cardiac diseases can aid in differentiation from other vestibular disorders. Early identification of CV would reduce morbidity and mortality associated with cardiac syncope. Keywords Cardiogenic vertigo · Syncope · Bradyarrhythmia · Sick sinus syndrome · Vestibular paroxysmia
Introduction
Hyun Ah Kim and Jinhee Ahn contributed equally to this work. * Kwang‑Dong Choi [email protected] 1
Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea
Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Pusan, South Korea
2
3
Division of Cardiology, Department of Internal Medicine, Brain Research Institute, Keimyung University School of Medicine, Daegu, South Korea
4
Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Pusan, South Korea
Cardiovascular disease is the
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