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The Dizzy Patient: Consider a Second Diagnosis
Roeland B van Leeuwen1, Carla Colijn, Erik van Wensen
1Apeldoorn Dizziness Centre, Gelre Hospital Apeldoorn, Apeldoorn, The Netherlands.
Background:
Many patients with dizziness complain about >1 type of dizziness and therefore there may be ≥2 coexisting diagnoses.
Objective:
To determine how often a second or third diagnosis is present in a patient with dizziness and to establish what are the most common combinations of diagnoses.
Study Design:
Prospective, observational study in a tertiary center.
Results:
A consecutive cohort of 621 patients was included in the study. In 187 patients (30.1%) a second diagnosis was present. Within this group a third diagnosis was present in 35 (5.6%) patients. The most common second diagnosis was an anxiety disorder (50.1%).
Conclusions:
Patients with dizziness frequently present themselves with >1 type of dizziness caused by 2 or 3 different diseases. In our study 30% of patients with dizziness have >1 diagnosis. Anxiety disorder is the most common second diagnosis.
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Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.

