What complications are associated with carotid sinus massage?
Complications resulting from carotid sinus massage include cardiac arrhythmias and neurologic sequelae. Fatal arrhythmias are extremely uncommon and have generally only occurred in patients with underlying heart disease undergoing therapeutic rather than diagnostic massage.
What is a contraindication to performing a carotid massage?
Absolute contraindications to carotid sinus massage include myocardial infarction, transient ischemic attack or stroke within the preceding three months. A history of ventricular fibrillation or tachycardia, or a previous adverse reaction to carotid sinus massage are also absolute contraindications.
What happens when you massage the carotid sinus?
A normal response to carotid sinus massage is a transient decrease in the sinus rate and a slowing of atrioventricular nodal conduction. Carotid sinus massage may also induce a decrease in the amplitude of the P wave.
Is it safe to massage carotid artery?
Complications. Carotid sinus massage is safe if done carefully. CSM is contraindicated in patients with a history of cerebrovascular disease or carotid bruits, because it can cause cerebrovascular accident (CVA, stroke).
Why is it important not to massage the carotid artery?
Massage of the carotid sinus is contraindicated in patients with diseased carotid arteries because of the risk of cerebrovascular accident. In rare instances, carotid sinus massage may initiate ventricular tachycardia.
How can the carotid sinus cause sudden death?
Carotid sinus reflex death is a potential etiology of sudden death in which manual stimulation of the carotid sinus allegedly causes strong glossopharyngeal nerve (Vagus nerve is for aortic arch baroreceptors) impulses leading to terminal cardiac arrest.
Can you feel carotid sinus?
The carotid sinus, or carotid bulb, is a widening of a carotid artery at its main branch point. The carotid sinus contains sensors that help regulate blood pressure. The carotid artery pulse can normally be felt in the neck by pressing the fingertips against the side of the windpipe, or trachea.
Can carotid massage cause death?
Carotid sinus reflex death A carotid massage can also possibly dislodge a thrombus, or some plaque. This could lead to any number of life-threatening effects, including stroke.
Is carotid massage a vagal maneuver?
In addition to these, your doctor may sometimes try another vagal maneuver (called carotid sinus massage) in the emergency room to help slow your heart rate. This technique should only be performed by a doctor.
How do you stimulate the carotid sinus?
The pulse generator delivers activation energy (voltage range 1-7.5 V) through electrode leads to stimulate the carotid sinus, and then the triggered baroreceptors send signals to the brain, which are interpreted as a rise in blood pressure.
What happens if you press on your carotid artery?
If you press gently on either side of your windpipe, in your neck, you may feel pulsations from the carotid arteries. Like any artery in the body, the carotid arteries may become diseased and blocked inside, either partly or completely.
Are there any contraindications to carotid sinus massage?
Contraindications to CSM were the presence of a carotid bruit, a known carotid stenosis >50%, a history of myocardial infarction or stroke within the preceding 3 months or a history of ventricular arrhythmias or symptomatic bradyarrhythmias [ 3 ]. All patients gave informed consent prior to CSM.
Why do you need a carotid sinus massage?
SIR—Carotid sinus massage (CSM) is a useful diagnostic tool in the investigation of unexplained falls and syncope [1].
Can a carotid sinus massage cause an AV block?
Carotid sinus massage can cause AV block but generally does not terminate the AT. Adenosine can slow but not terminate the AT. Only beta blockers have been useful in termination of paroxysmal (but not incessant) automatic AT. Termination of automatic AT is usually preceded by a cool-down phenomenon of the AT rate.1
What are the signs of carotid sinus syndrome?
Indications for CSM were recurrent unexplained falls or syncope together with a clinical suspicion that carotid sinus syndrome may be the underlying diagnosis.
