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Incidence of Complications After Carotid Sinus Massage in Old er Patients with Syncope
Abstract
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.
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“When pooling the data from four studies 90,95-97 in which 8720 patients were analysed, TIAs or strokes were observed in 21 (0.24%).”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [95]
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Wu, T. C. (2011) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.5.2011.tde-05052011-123534
Performing Carotid Sinus Massage
Maggi, R., & Brignole, M. (2007) · Springer eBooks · doi:10.1007/978-88-470-0636-2_20
An 85-Year-Old Women With a History of Falls
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Metadata
- Authors
- Munro, N. C., Mclntosh, S., Lawson, J., Morleyf, C. A., Sutton, R., & Kenny, R. A.
- Affiliations
- Royal Victoria Infirmary (GB)
- St. Luke's Hospital (GB)
- Chelsea and Westminster Hospital (GB)
- Corresponding author
- Kenny, Rose Anne
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 1994-12
- Volume
- 42
- Issue
- 12
- Pages
- 1248-1251
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- OpenAlex
- W2159067126
- Cited by
- 126
- References
- 17
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 5 · 2018: 8 · 2017: 5 · 2016: 5 · 2015: 1 · 2014: 5 · 2013: 3 · 2012: 2
- FWCI
- 3.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cerebrovascular and Carotid Artery Diseases
- Keywords
- carotid sinus massage, neurological complications, syncope, carotid sinus syndrome, elderly patients, pyramidal signs, visual field defects, atropine, dizziness, unexplained falls, complication incidence, contraindications
- MeSH terms
- Contraindications, Aged, Aged, 80 and over, Atropine, Carotid Sinus, Humans, Male, Massage, Nervous System Diseases, Syncope, Time Factors, Incidence, Supine Position
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