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Incidence of Complications After Carotid Sinus Massage in Old er Patients with Syncope
Author(s) -
Munro Neil C.,
Mclntosh Shona,
Lawson Joanna,
Morleyf Chris A.,
Sutton Richard,
Kenny Rose Anne
Publication year - 1994
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1994.tb06505.x
Subject(s) - medicine , massage , carotid sinus , incidence (geometry) , sinus (botany) , syncope (phonology) , stroke (engine) , surgery , cardiology , blood pressure , mechanical engineering , physics , alternative medicine , botany , pathology , optics , biology , genus , engineering
OBJECTIVE: To review the incidence of neurological complications occurring after carotid sinus massage performed for diagnostic purposes. DESIGN: Case review and comparison with previously published work. SETTING: Syncope Clinic, Royal Victoria Infirmary, Newcastle‐upon‐Tyne, and Chelsea and Westminster Hospital, London. PARTICIPANTS: Patients undergoing investigation of dizziness, syncope, or unexplained falls. METHODS: Carotid sinus massage performed for 5 seconds in both supine and erect postures, both before and after atropine. Contraindications to carotid sinus massage were the presence of carotid bruits, recent myocardial or cerebral ischemia, or previous ventricular tachyarrhythmias. RESULTS: Two cases of neurological complications were reported from a total of 500 patients (2000 massage episodes) investigated in one center, giving an incidence of 0.1%. Combining this data with another center performing investigations in a similar fashion, seven neurological complications arose from a total of 5000 massage episodes, an incidence of 0.14%. Reported complications were pyramidal signs in five cases and visual field defects in two. Pyramidal weakness persisted in one case with a pre‐existing stroke on the same side, and a visual field loss was permanent in one. CONCLUSIONS: Neurological complications following carotid sinus massage for diagnosis of the carotid sinus syndrome are uncommon and usually transient. Contraindications to carotid sinus massage should be respected and the standardized technique used.