In view of these high diagnostic rates in selected patients, we considered the possibility that haemodynamic responses to massage might be modified by ageing alone and that the accepted diagnostic criteria in particular for vasodepressor carotid sinus syndrome may require re-evaluation in elderly patients.
The purpose of this study was to define heart rate and blood pressure responses to surpine and upright carotid sinus massage in healthy elderly subjects and thus to assess the validity of accepted diagnostic criteria for carotid sinus syndrome in this age group.
Carotid sinus syndrome is an important but frequently overlooked cause of dizziness and syncope .
The incidence of carotid sinus syndrome increases with age .
Management: In patients with carotid sinus syndrome and vasovagal syndrome, factors which can precipitate syncope were explained to the patient, in particular tight collars, sudden head turning, looking up, wearing a cervical collar, warm atmospheres, prolonged standing, fasting, fatigue and dehydration.
Five patients with predominant cardioinhibitory carotid sinus syndrome and more than two syncopal episodes had dual chamber pacemakers implanted.
Of interest is the diagnostic overlap between orthostatic hypotension, vasodepressor carotid sinus syndrome and vasovagal syndrome.
Awareness of the possible contribution of carotid sinus syndrome and, in particular, vasodepressor carotid sinus hypersensitivity to syncope and falls greatly enhances the diagnostic yield.