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[Usefulness of a protocol for carotid sinus massage in supine and erect postures in patients with syncope without other cardiovascular or neurological diseases].
G Ital Cardiol. 1995 May; 25(5):553-60.GI

Abstract

BACKGROUND

Carotid sinus massage is a first level test when investigating the cause of syncope. It is normally performed in the supine and erect positions. However, there is no standard complete protocol. So we have devised a new protocol to evaluate the utility of carotid sinus massage in different postures and the influence of patients age on the response.

METHODS

Two groups of subjects were selected: a group of 167 patients (mean age 50 ys +/- 18, 105 males, 62 females) with a history of syncope without cardiovascular and neurological disease and 20 asymptomatic control subjects (mean age 52 ys +/- 13, 11 males, 9 females). Carotid sinus massage was performed supine, just after passive tilt, after 5 minutes of tilt and just after passive return to supine. If a pause > 3" was detected, the protocol was repeated after atropine i.v. injection.

DEFINITIONS

Borderline vasodepressor: blood pressure reduction > 30 but < 50 mm Hg without symptoms; vasodepressor: blood pressure reduction > 50 mm Hg or > 30 mm Hg with symptoms like dizziness, vertigo or syncope; cardioinhibitory: pause > 3"; mixed: cardioinhibitory with blood pressure reduction > 30 mm Hg after atropine.

RESULTS

Carotid sinus massage gave all informations in the supine position in 14 (12%) patients, after passive tilt in 67 (57%), after 5 minutes of tilt in 30 (26%), and after return to supine in 6 (5%). The responses were: 13 (8%) borderline vasodepressor, 32 (19%) vasodepressor, 2 (1%) cardioinhibitory, 70 (42%) mixed, 50 (30%) negative. Positive responses were more frequent in patients over 45 years (90% versus 43%). In the control group only 3 (15%) positive responses were elicited (2 borderline vasodepressor, and 1 vasodepressor, all in subjects over 45).

CONCLUSIONS

This protocol for carotid sinus massage evidenced positive responses in 70% of patients with syncope without cardiovascular and neurological disease; cardioinhibitory responses are rare (2%); positive responses are more frequent in patients over 45 years; the protocol specificity was 85%.

Authors+Show Affiliations

Divisione di Cardiologia, Ospedale Civile di Asti.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
English Abstract
Journal Article

Language

ita

PubMed ID

7642060

Citation

Bocchiardo, M, et al. "[Usefulness of a Protocol for Carotid Sinus Massage in Supine and Erect Postures in Patients With Syncope Without Other Cardiovascular or Neurological Diseases]." Giornale Italiano Di Cardiologia, vol. 25, no. 5, 1995, pp. 553-60.
Bocchiardo M, Alciati M, Buscemi A, et al. [Usefulness of a protocol for carotid sinus massage in supine and erect postures in patients with syncope without other cardiovascular or neurological diseases]. G Ital Cardiol. 1995;25(5):553-60.
Bocchiardo, M., Alciati, M., Buscemi, A., Cravetto, A., Richiardi, E., & Gaita, F. (1995). [Usefulness of a protocol for carotid sinus massage in supine and erect postures in patients with syncope without other cardiovascular or neurological diseases]. Giornale Italiano Di Cardiologia, 25(5), 553-60.
Bocchiardo M, et al. [Usefulness of a Protocol for Carotid Sinus Massage in Supine and Erect Postures in Patients With Syncope Without Other Cardiovascular or Neurological Diseases]. G Ital Cardiol. 1995;25(5):553-60. PubMed PMID: 7642060.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Usefulness of a protocol for carotid sinus massage in supine and erect postures in patients with syncope without other cardiovascular or neurological diseases]. AU - Bocchiardo,M, AU - Alciati,M, AU - Buscemi,A, AU - Cravetto,A, AU - Richiardi,E, AU - Gaita,F, PY - 1995/5/1/pubmed PY - 1995/5/1/medline PY - 1995/5/1/entrez SP - 553 EP - 60 JF - Giornale italiano di cardiologia JO - G Ital Cardiol VL - 25 IS - 5 N2 - BACKGROUND: Carotid sinus massage is a first level test when investigating the cause of syncope. It is normally performed in the supine and erect positions. However, there is no standard complete protocol. So we have devised a new protocol to evaluate the utility of carotid sinus massage in different postures and the influence of patients age on the response. METHODS: Two groups of subjects were selected: a group of 167 patients (mean age 50 ys +/- 18, 105 males, 62 females) with a history of syncope without cardiovascular and neurological disease and 20 asymptomatic control subjects (mean age 52 ys +/- 13, 11 males, 9 females). Carotid sinus massage was performed supine, just after passive tilt, after 5 minutes of tilt and just after passive return to supine. If a pause > 3" was detected, the protocol was repeated after atropine i.v. injection. DEFINITIONS: Borderline vasodepressor: blood pressure reduction > 30 but < 50 mm Hg without symptoms; vasodepressor: blood pressure reduction > 50 mm Hg or > 30 mm Hg with symptoms like dizziness, vertigo or syncope; cardioinhibitory: pause > 3"; mixed: cardioinhibitory with blood pressure reduction > 30 mm Hg after atropine. RESULTS: Carotid sinus massage gave all informations in the supine position in 14 (12%) patients, after passive tilt in 67 (57%), after 5 minutes of tilt in 30 (26%), and after return to supine in 6 (5%). The responses were: 13 (8%) borderline vasodepressor, 32 (19%) vasodepressor, 2 (1%) cardioinhibitory, 70 (42%) mixed, 50 (30%) negative. Positive responses were more frequent in patients over 45 years (90% versus 43%). In the control group only 3 (15%) positive responses were elicited (2 borderline vasodepressor, and 1 vasodepressor, all in subjects over 45). CONCLUSIONS: This protocol for carotid sinus massage evidenced positive responses in 70% of patients with syncope without cardiovascular and neurological disease; cardioinhibitory responses are rare (2%); positive responses are more frequent in patients over 45 years; the protocol specificity was 85%. SN - 0046-5968 UR - https://www.unboundmedicine.com/medline/citation/7642060/[Usefulness_of_a_protocol_for_carotid_sinus_massage_in_supine_and_erect_postures_in_patients_with_syncope_without_other_cardiovascular_or_neurological_diseases]_ L2 - https://medlineplus.gov/fainting.html DB - PRIME DP - Unbound Medicine ER -