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References in periodicals archive ?
In the setting of head or neck cancer, the physician should have a high index of suspicion, because syncope may arise due to carotid sinus hypersensitivity (secondary to mechanical compression of the carotid sinus) and glossopharyngeal neuralgia (from tumour-induced irritation of the glossopharyngeal nerve), examples of which have been previously reported (8-10).
The statement says that "particular emphasis (in the elderly) should be given to the impact of polypharmacy, orthostatic intolerance, autonomic dysfunction, and carotid sinus hypersensitivity."
Treatment of cardiovascular disorders is perceived to be beneficial by 76% of patients [17] and a small study suggests the insertion of permanent pacemakers prevents unexplained falls in cardioinhibitory carotid sinus hypersensitivity [24].
Carotid sinus hypersensitivity: asystole exceeding 3 s (cardio-inhibitory sub-type), a fall in systolic blood pressure exceeding 50 mmHg in the absence of cardio-inhibition (vasodepressor sub-type) or both (mixed sub-type) during 5 s of carotid sinus massage [16].
Abnormal cardiovascular findings were present in 20/26 patients: orthostatic hypotension (19%), carotid sinus hypersensitivity (73%), vasovagal hypersensitivity (15%) and arrhythmia (8%) (Table II).
Carotid sinus hypersensitivity: prevalence and associated symptoms
Falls Unexplained Recurrent (n = 6) (n = 2) Carotid sinus hypersensitivity (total) 4 2 mixed 0 0 vasodepressor 3 1 cardio-inhibitory 1 1 Symptoms during CSM LOC and amnesia 0 0 presyncope 1 1 dizziness 2 0 Unexplained Unexplained and recurrent LOC (n = 8) (n = 26) Carotid sinus hypersensitivity (total) 6 7 mixed 0 3 vasodepressor 2 1 cardio-inhibitory 4 3 Symptoms during CSM 4 3 LOC and amnesia 2 4 presyncope 0 0 dizziness Total (n = 26) Carotid sinus hypersensitivity (total) 19 mixed 3 vasodepressor 7 cardio-inhibitory 9 Symptoms during CSM LOC and amnesia 7 presyncope 8 dizziness 2 CSM = Carotid sinus massage; LOC = loss of consciousness.
Attributable diagnoses were assigned if symptoms were reproduced during investigations: four patients had orthostatic hypotension, eight had cardio-inhibitory carotid sinus hypersensitivity, three had mixed carotid sinus hypersensitivity, three had vasovagal hypersensitivity, two had arrhythmia and two had benign positional vertigo.
Symptomatic isolated carotid sinus hypersensitivity: natural history and results of treatment with anticholingeric drugs or pacemakers.
Enhanced vagal activity and normal arginine vasopressin response in carotid sinus syndrome: implications for a central abnormality in carotid sinus hypersensitivity. Cardiovasc Res 1987;21:545-50.
For those with vasodepressor carotid sinus hypersensitivity, 60% had either vasovagal syncope and/or postural hypotension.