[Cardiovascular aspects of vertigo]

True vertigo described as a sensation of body or surrounding objects rotation is seldom of cardiovascular origin. The main causes are caused by ear pathology, neurologic pathology or are of toxic origin. Patients talk frequently of vertigo to describe symptoms in relation with a fall of the brain blood output. These dizziness feelings are frequently of cardiovascular origin and may be associated with syncope which represents a more important fall in the brain blood pressure. Medical history, physical examination, electrocardiogram represents the cornerstones of the cardiological workout allowing about 50% of likely diagnosis. The cardiologist will also have to distinguish between a disease of benign prognosis and a disease possibly associated with future sudden cardiac death. The main cardiological causes are: neurally mediated hypotension, orthostatic hypotension, cardiac arrhythmias, other cardiac or pulmonary diseases. Neurological, metabolic or psychiatric causes occur much less frequently. Most commonly used diagnostic tests include the resting electrocardiogram, the stress test, cardiac echography, holter techniques, tilt testing, cardiac and coronary angiography, electrophysiologic testing. However, despite an extensive workout some causes of dizziness or syncope remain unclear.