Carotid Sinus Massage in Syncope Evaluation: A Nonspecific and Dubious Diagnostic Method

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorWU, Tan Chen
dc.contributor.authorHACHUL, Denise T. L.
dc.contributor.authorDARRIEUX, Francisco Carlos da Costa
dc.contributor.authorI, Mauricio Scanavacca
dc.date.accessioned2018-09-13T15:28:15Z
dc.date.available2018-09-13T15:28:15Z
dc.date.issued2018
dc.description.abstractBackground: Carotid sinus hypersensitivity (CSH) is a frequent finding in the evaluation of syncope. However, its significance in the clinical setting is still dubious. A new criterion was proposed by Solari et al. with a symptomatic systolic blood pressure (SBP) cut-off value of <= 85 mmHg to refine the vasodepressor (VD) response diagnosis. Objective: To determine and compare the response to carotid sinus massage (CSM) in patients with and without syncope according to standard and proposed criteria. Methods: (3M was performed in 99 patients with and 66 patients without syncope. CSH was defined as cardioinhibitory (CI) for asystole >= 3 seconds, or as VD for SBP decrease >= 50 mmHg. Results: No differences in the hemodynamic responses were observed during CSM between the groups, with 24.2% and 25.8% CI, and 8.1% and 13.6% VD in the symptomatic and asymptomatic groups, respectively (p = 0.466). A p value < 0.050 was considered statistically significant. During the maneuvers, 45 (45.45%) and 34 (51.5%) patients in the symptomatic and asymptomatic groups achieved SBP below <= 85 mmHg. Symptoms were reported especially in those patients in whom CSM caused a SBP decrease to below 90 mmHg and/or asystole > 2.5 seconds, regardless of the pattern of response or the presence of previous syncope. Conclusion: The response to CSM in patients with and without syncope was similar; therefore, CSH may be an unspecific condition. Clinical correlation and other methods of evaluation, such as long-lasting ECG monitoring, may be necessary to confirm CSH as the cause of syncope.
dc.description.indexMEDLINE
dc.identifier.citationARQUIVOS BRASILEIROS DE CARDIOLOGIA, v.111, n.1, p.84-91, 2018
dc.identifier.doi10.5935/abc.20180114
dc.identifier.issn0066-782X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/28405
dc.language.isoeng
dc.publisherARQUIVOS BRASILEIROS CARDIOLOGIA
dc.relation.ispartofArquivos Brasileiros de Cardiologia
dc.rightsopenAccess
dc.rights.holderCopyright ARQUIVOS BRASILEIROS CARDIOLOGIA
dc.subjectSyncope
dc.subjectCarotid Sinus / physiopathology
dc.subjectAccidental Falls
dc.subjectAged
dc.subjectHypotension
dc.subject.otherorthostatic hypotension
dc.subject.otherunexplained syncope
dc.subject.otherolder-adults
dc.subject.otherhypersensitivity
dc.subject.otherfalls
dc.subject.otherprevalence
dc.subject.otherreflex
dc.subject.wosCardiac & Cardiovascular Systems
dc.titleCarotid Sinus Massage in Syncope Evaluation: A Nonspecific and Dubious Diagnostic Method
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.citation.scopus4
hcfmusp.contributor.author-fmusphcTAN CHEN WU
hcfmusp.contributor.author-fmusphcDENISE TESSARIOL HACHUL
hcfmusp.contributor.author-fmusphcFRANCISCO CARLOS DA COSTA DARRIEUX
hcfmusp.contributor.author-fmusphcMAURICIO IBRAHIM SCANAVACCA
hcfmusp.description.beginpage84
hcfmusp.description.endpage91
hcfmusp.description.issue1
hcfmusp.description.volume111
hcfmusp.origemWOS
hcfmusp.origem.pubmed30110049
hcfmusp.origem.scieloSCIELO:S0066-782X2018000700084
hcfmusp.origem.scieloSCIELO:S0066-782X2018001300084
hcfmusp.origem.scopus2-s2.0-85052294637
hcfmusp.origem.wosWOS:000441438000016
hcfmusp.publisher.cityRIO DE JANEIRO
hcfmusp.publisher.countryBRAZIL
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hcfmusp.scopus.lastupdate2024-05-10
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