I was remembering that no matter how well I tried to teach those amazing nurses how to massage his
carotid sinus, his heart responded only to my touch.
Mass lesions of the neck involving the
carotid sinus or airway are a potentially modifiable cause of sinus bradycardia and sleep apnea.
Carotid body tumor presenting with
carotid sinus syndrome.
The initial strategy should be to terminate an SVT with a vagal manoeuvre, such as
carotid sinus massage, after excluding any carotid artery bruit.
* Vagal manoeuvres like
Carotid sinus massage, Valsalva maneuver or phaiyngeal stimulation can abort the re-entrant variety of PSVT.
This elevates the excitability of the nerve endings which increases the activity of the
carotid sinus nerve of the carotid body for eliciting the chemoreflex.
Other precipitating factors include foreign body ingestion (iatrogenic secondary to instrumentation and laryngoscopy),
carotid sinus massage (3) and even acupuncture (6).
The pressure on
carotid sinus baroreceptors, which are located just cephalad to the bifurcation of the common carotid artery, results in bradycardia, hypotension, or combination of both.
Bradycardia, related to manipulation of the
carotid sinus baroreceptors located in the carotid bulb, may occur during the procedure just after the stent implantation and/or balloon angioplasty (Martinez-Fernandez et al., 2008).
(9) Horner syndrome may result from cervical sympathetic chain invasion, and syncope can occur after
carotid sinus compression.
Our patient did not respond to
carotid sinus massage and asthma precluded the use of adenosine and beta blockers.
The system consists of a battery-powered implantable generator inserted under the skin near the collarbone and two
carotid sinus leads, which run from the generator to the left and right carotid sinuses in the neck.