Urgent message: Most cases of vertigo are benign. This includes etiologies such as benign paroxysmal position vertigo, labyrinthitis, and psychogenic causes. However, there are serious, “can’t miss” etiologies which should be considered during the urgent care evaluation of a dizzy patient. Cody McCoy, DO and Michael Weinstock, MD Citation: McCoy C, Weinstock M. A cause of dizziness not to be missed. J Urgent Care Med. 2023;17(5):13-16. Key words: dizziness, vertigo, disequilibrium, BPPV INTRODUCTION Dizziness presents …
Read MoreA 73-Year-Old Man with a 2-Week History of Palpitations
Case The patient is a 73-year-old male smoker who complains that he has had intermittent palpitations for the past 2 weeks. He denies chest pain, diaphoresis, fever, or dizziness. He uses home oxygen, 2 L/min, but denies any new shortness of breath. Upon exam, you find: General: Alert and oriented x 3 Lungs: Scattered minimal wheezing, which is symmetric Cardiovascular: Regular and tachycardic without murmur, rub, or gallop Abdomen: Soft and nontender without rigidity, rebound, …
Read MoreA 62-Year-Old Woman with Dizziness and Palpitations
Case The patient is a 62-year-old woman who presents to the urgent care center after 1 hour of intermittent dizziness and feeling of palpitations. She has no chest pain, fever, vomiting, or diarrhea. Further history reveals that she has a history of anxiety, which is manifested by intermittent feeling of heart “palpitations.” Her primary care doctor is treating her with a selective serotonin reuptake inhibitor (SSRI) for anxiety. Upon exam, you find: General: Alert and …
Read MoreThe Dizzy Patient in the Urgent Care Setting
Urgent message: “Dizziness” can prove to be one of the more vexing complaints encountered in urgent care. To provide appropriate care, the clinician must understand whether the patient is experiencing near-syncope, disequilibrium, ill-defined light-headedness, or vertigo. Martin Samuels, MD, DSc (hon), FAAN, MACP The problem of dizziness can be one of the most exasperating in the practice of medicine. Physicians all know that sinking feeling elicited by the patient who sits down and, when one …
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