Document Detail


Incidence of complications after carotid sinus massage in older patients with syncope.
MedLine Citation:
PMID:  7983286     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
N C Munro; S McIntosh; J Lawson; C A Morley; R Sutton; R A Kenny
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Publication Detail:
Type:  Case Reports; Clinical Trial; Journal Article; Multicenter Study; Review    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  42     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1995-01-03     Completed Date:  1995-01-03     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1248-51     Citation Subset:  IM    
Affiliation:
Cardiovascular Investigation Unit, Royal Victoria Infirmary, Newcastle-upon-Tyne, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Atropine / diagnostic use
Carotid Sinus*
Humans
Incidence
Male
Massage / adverse effects*,  contraindications
Nervous System Diseases / epidemiology*,  etiology*
Supine Position
Syncope / diagnosis*,  etiology
Time Factors
Chemical
Reg. No./Substance:
51-55-8/Atropine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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