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Carotid Sinus Hypersensitivity

Afsha Rais Kaisani, FAAFP, MD, Tasaduq Hussain Mir, FAAFP, MD and Niyomi De Silva, MD Reviewed 04/2024
 


BASICS

Carotid sinus hypersensitivity is an exaggerated response to stimulation or pressure applied to the carotid sinuses that results clinically as syncope or presyncope. 

DESCRIPTION

  • The carotid sinu...

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 isolated CSH in asymptomatic individuals. Educate patients about CSH and monitoring and avoidance of triggers.

  • High-dietary salt intake and increa...

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
McDonald C, Pearce MS, Newton JL, et al. Modified criteria for carotid sinus hypersensitivity are associated with increased mortality in a population-based study. Europace. 2016;18(7):1101...

ADDITIONAL READING

  • Amin V, Pavri BB. Carotid sinus syndrome. Cardiol Rev. 2015;23(3):130-134.

  • Kapoor JR. Carotid sinus hypersensitivity: a diagnostic pearl. ...

SEE ALSO

Syncope 

CODES

ICD10

G90.01 Carotid sinus syncope 

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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