Carotid Sinus Syncope

Diagnosis:

A type of neurally mediated syncope
A clinical diagnosis. Occasionally carotid sinus massage is used.
Carotid sinus massage:

  • False positives occur i.e. if positive it is not necessarily the cause of syncope
  • Observe contraindications & procedural care
  • Must have negative results for other causes of syncope

Positive if with 5 seconds of unilateral longitudinal massage:

  • Paroxysmal AV nodal block
  • Asystole for at least 3 seconds
  • BP drop >50 mmHg systolic or >30 mmHg diastolic

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