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Carotid Sinus Hypersensitivity

Amal Shine, MD, Anub G. John, MD and Hugh R. Peterson, MD, FACP Reviewed 06/2018
 


BASICS

DESCRIPTION

  • The carotid sinus, located at the bifurcation of the internal and external carotid arteries, contains baroreceptors that are responsive to increases or decreases in arterial pressure...

DIAGNOSIS

HISTORY

  • Recurrent syncope: usually sudden, unexplained, of short duration, seemingly spontaneous, and with complete recovery, although fractures and other injuries may occur

  • Unexplained falls:...

TREATMENT

GENERAL MEASURES

  • No treatment is required for asymptomatic individuals.

  • High-dietary salt intake and increased fluid intake may be helpful to maintain intravascular volume in patients with vas...

ONGOING CARE

PATIENT EDUCATION

  • Avoid precipitating maneuvers (as described above) that place pressure on the neck, such as tight collars and neckties.

  • With syncope, restrict driving or other potentially...

REFERENCES

1
1 Parry SW, Richardson DA, O’Shea D, et al. Diagnosis of carotid sinus hypersensitivity in older adults: carotid sinus massage in the upright position is essential. Heart.  2000;83(1)...

ADDITIONAL READING

Moore A, Watts M, Sheehy T, et al. Treatment of vasodepressor carotid sinus syndrome with midodrine: a randomized, controlled pilot study. J Am Geriatr Soc.  2005;53(1):114–118...

SEE ALSO

Syncope 

CODES

ICD10

G90.01 Carotid sinus syncope 

ICD9

337.01 Carotid sinus syndrome 

SNOMED

  • 9631000119102 Carotid sinus hypersensitivity

  • 51723007 Carotid sinus syncope (disorder)

CLINICAL PEARLS

  • Consider CSH as a potential cause for syncope, dizziness, or unexplained falls, especially in the elderly.

  • Diagnose CSH via CSM (using firm pressure for 5 to 10 seconds), producing asys...

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