Carotid sinus syndrome is a condition characterized by paroxysmal and repeated fainting, most often occurring when the head is turned to the side. It is a serious cardiac condition as it can cause bradycardia and even a long break in the heartbeat. What are the causes and other symptoms of the disease? What is the treatment of patients with hypersensitive carotid sinus syndrome?

Carotid sinus syndrome( Sinus carotici syndrome ) is a disease whose essence is the hypersensitivity of the nerve plexus in the carotid area. Even gentle pressure on these nerves causes the body to overreact in the form of dizziness and fainting.

Hypersensitive Carotid Sinus Syndromecauses about 1 percent of syncope. Research shows that older people, especially men, most often struggle with it.

Contents:

  1. Carotid sinus syndrome: risk factors
  2. Carotid sinus syndrome: causes
  3. Carotid sinus syndrome: symptoms
  4. Carotid sinus syndrome: diagnosis
  5. Carotid sinus syndrome: treatment

Carotid sinus syndrome: risk factors

People struggling with

are primarily at risk of carotid sinus syndrome.
  • hypertension
  • atherosclerosis
  • ischemic heart disease
  • with dementia with Lewy bodies

The risk of developing the disease also increases in people who take certain medications, incl. beta-blockers or cardiac glycosides.

Carotid sinus syndrome: causes

Carotid sinusis the place on the neck just above the exit point of the internal carotid artery from the common carotid artery, which is where the heart rate is most often checked. In its wall there are receptors sensitive to pressure - baroreceptors and mechanoreceptors, which are the endings of the vascular fibers of the glossopharyngeal and vagus nerves. These receptors, under the influence of changes in blood pressure, send information about the level of blood pressure directed to the brain through the nerve fibers to the nucleus of the vagus nerve and to the vasomotor center in the brainstem. If it is too high, it's normal for your heart to slow down. However, in the sinus syndromecarotid, these receptors are hypersensitive to a normal stimulus. When the blood pressure level inside the carotid artery rises, even in a mild way, the receptors are over-irritated. Then the heart rate slows down sharply and the blood pressure drops.

Carotid sinus syndrome: symptoms

A sharp drop in blood pressure may cause dizziness and fainting due to insufficient oxygenation, and thus - the blood supply to the brain. Repeated syncope is paroxysmal in nature and most often occurs when turning the head sideways, coughing or exercising, or when there is an increase in blood pressure in the carotid artery.

Carotid sinus syndrome: diagnosis

The diagnosis is made on the basis of a history and physical examination, during which the doctor may find bradycardia or a drop in blood pressure.

Diagnosis, however, requires the exclusion of other diseases that cause syncope, such as Morgagni-Adams-Stokes syndrome, epilepsy, hypoglycaemia, vascular collapse, myocardial ischemia or pulmonary embolism. Therefore,carotid sinus massagemay be decisive. It is a test during which the carotid sinus artery is massaged for 5-10 seconds while monitoring the ECG and blood pressure of the patient. If you faint or your heart rate drops after the massage, blood pressure (or both) can be diagnosed for carotid sinus syndrome.

In patients who do not respond to carotid sinus massage, an EKG can be performed using the Holter method or electroencephalography (EEG) - a diagnostic method used to study the bioelectric function of the brain using an electroencephalograph. This type of examination is also recommended for people who cannot undergo a carotid sinus massage. These are patients who have had a heart attack and have transient cerebral ischemia (TIA). Contraindication to the massage is also the obstruction of the carotid artery.

Carotid sinus syndrome: treatment

Treatment of carotid sinus syndromeusually consists of administering parasympatholytic drugs (blocking the parasympathetic system, e.g. atropine) or stimulating the adrenergic system (the system involving part of the autonomic nervous system and the adrenal medulla) .

In severe cases, surgical treatment is indicated, involving either the denervation of the carotid sinus or the permanent implantation of a pacemaker.

Category:

Cardiology