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Conditions

Dizziness and vertigo triage

Office-first approach to dizziness/vertigo that prioritizes stroke and cardiac red-flag exclusion.

Last reviewed 2026-02-07|dizziness | vertigo | triage

Assessment priorities

  • Differentiate vertigo, presyncope, disequilibrium, and nonspecific lightheadedness.
  • Review orthostatic vitals, medication contributors, and hydration status.
  • Check focal neurologic findings, gait stability, and cardiovascular warning features.

Red flags

  • Acute focal neurologic deficit, severe ataxia, or persistent central-vertigo concern.
  • Syncope, chest pain, or arrhythmia concern accompanying dizziness.
  • Progressive severe symptoms with inability to ambulate safely.

Initial management

  • Stabilize immediate contributors such as dehydration or medication-related hypotension.
  • Use targeted outpatient workup when red flags are absent and follow-up is reliable.
  • Document escalation criteria if symptoms persist, worsen, or change pattern.

Follow-up and escalation

  • Arrange close follow-up for unresolved dizziness within a defined interval.
  • Escalate for recurrent syncope, neurologic progression, or new cardiopulmonary concerns.
  • Ensure explicit return precautions for stroke-like symptoms and sudden deterioration.