Hypersensitivity of carotid sinus. A forgotten cause of syncope and falls in the elderly. Its physiopathology is not clear even if it has many common points with neutrally mediated syncope. The diagnosis is usually clinical and the carotid sinus massage confirms it by reproducing the symptoms when it induces longer than three second asystole or blood pressure drops higher than 50 mmHg. Its treatment has many controversial points and the options are limited when it comes to the vasodepressor variety. In the cardio-inhibitory variety, the most accepted treatment is a pacemaker implant, nonetheless, the recurrence rates still high.

Author:Meztitilar Shakarn
Country:Sri Lanka
Language:English (Spanish)
Published (Last):7 June 2011
PDF File Size:7.91 Mb
ePub File Size:16.36 Mb
Price:Free* [*Free Regsitration Required]

Medwave se preocupa por su privacidad y la seguridad de sus datos personales. Palabras clave: syncope, neurally mediated faints, tilt table test, postural orthostatic intolerance, electrocardiogram, cardiac event monitor. Tabla 1. Figura 1. Se reconocen cuatro tipos de respuesta a la prueba de mesa basculante o prueba de mesa inclinada tilt test :.

Figura 2. Patrones de respuesta durante la prueba de mesa basculante. Figura 3. Respuesta vasovagal mixta durante la prueba de mesa basculante. Figura 4. Respuesta vasovagal cardioinhibitoria durante la prueba de mesa basculante.

En total se incluyeron 57 pacientes en el grupo marcapasos y 54 pacientes en el grupo control. Figura 5. Maniobra de Valsalva La maniobra de Valsalva se utiliza para evaluar la integridad de los arcos reflejos arteriales y cardiopulmonares. Figura 6. Maniobra de Valsalva. La prueba se considera positiva si se produce un incremento mayor de 20 latidos por minuto en ritmo sinusal con una dosis menor de 0,5 mg.

Fase 1: bradicardia sinusal progresiva. Fase 2: bloqueo AV de primero y segundo grado. Fase 5: taquicardia sinusal refleja Figura 7. Figura 7. Prueba de adenosina. La prueba se considera positiva cuando la fase tres es mayor a 10 segundos considerando posibles escapes ventriculares y es negativa cuando no existe fase 3 o la misma es menor a 10 segundos. Sin embargo, existe una constante controversia en cuanto al valor de la adenosina para identificar pacientes candidatos al implante de marcapasos.

Figura 8. Figura 9. Figura Bradicardia sinusal y paro sinusal en Holter 24 horas. Aumento del voltaje de la onda R en derivaciones antero laterales. Derivaciones del plano frontal. Syncope represents one of the most frequent reasons for consultation in the emergency department.

A proper identification will allow a precise etiologic approach and the optimization of delivery of health resources. Once knowing the classification of syncope; it is the clinical interrogatory what enables to discriminate which of these patients present with a neurogenic mediated syncope or a cardiac mediated syncope. The use of diagnostic methods such as the tilt test, will clarify what type of neurally mediated syncope predominates in the patient.

The electrocardiogram is the cornerstone in the identification of those patients who had a true episode of self-limited or aborted sudden death as the first manifestation of their syncope, a fact which provides prognostic and therapeutic information that will impact the morbidity and mortality. Syncope: electrocardiogram and autonomic function tests. Medwave ;16 Suppl 4 :e doi: Ficha PubMed. Contacto English Email: Clave:. Neurol Clin. Clinical practice.

Neurocardiogenic syncope. N Engl J Med. PubMed Benditt DG. Cardiovascular Medicine. Edinburgh: Churchill Livingstone; Role of autonomic reflexes in syncope associated with paroxysmal atrial fibrillation. J Am Coll Cardiol. Transient loss of consciousness: the value of the history for distinguishing seizure from syncope. J Neurol.

Historical criteria that distinguish syncope from seizures. Is syncope a risk factor for poor outcomes? Comparison of patients with and without syncope.

Am J Med. PubMed Jardine DL. Vasovagal syncope: new physiologic insights. Cardiol Clin. Neurally mediated syncope and syncope due to autonomic failure: differences and similarities. J Clin Neurophysiol. Syncope associated with supraventricular tachycardia. An expression of tachycardia rate or vasomotor response? Analysis of the pre-syncopal phase of the tilt test without and with nitroglycerin challenge.

Vasovagal Syncope International Study. Rev Esp Cardiol. Postural orthostatic tachycardia syndrome POTS. BMJ Case Rep. Is there any point to vasovagal syncope? Clin Auton Res. Symptoms associated with orthostatic hypotension in pure autonomic failure and multiple system atrophy. Guidelines for the diagnosis and management of syncope version Eur Heart J. Guidelines on management diagnosis and treatment of syncope--update Cardiac pacing for prevention of recurrent vasovagal syncope.

Ann Intern Med. A randomized trial of permanent cardiac pacing for the prevention of vasovagal syncope. A randomized, double-blind, placebo-controlled study of permanent cardiac pacing for the treatment of recurrent tilt-induced vasovagal syncope.

Dual-chamber pacing in the treatment of neurally mediated tilt-positive cardioinhibitory syncope : pacemaker versus no therapy: a multicenter randomized study.

Mechanism of 'inappropriate' sinus tachycardia. Role of sympathovagal balance. Basic autonomic test. O'Mahony D. Pathophysiology of carotid sinus hypersensitivity in elderly patients. Carotid sinus syndrome--clinical characteristics in elderly patients.

Age Ageing. Diagnostic utility of mechanical, pharmacological and orthostatic stimulation of the carotid sinus in patients with unexplained syncope. The management of patients with carotid sinus syndrome: is pacing the answer? PubMed Low PA. Laboratory evaluation of autonomic function.

En: Clinical autonomic disorders: Evaluation and Management; Vasovagal susceptibility to nitrate or isoproterenol head-up tilt. Am J Cardiol. The normal range and determinants of the intrinsic heart rate in man.

Cardiovasc Res. Single-stage adenosine tilt testing in patients with unexplained syncope. J Cardiovasc Electrophysiol. Induction of neurally mediated syncope with adenosine. The diagnostic value of ATP testing in patients with unexplained syncope. Clinical features of adenosine sensitive syncope and tilt induced vasovagal syncope. Mechanism of syncope in patients with positive adenosine triphosphate tests.


Síndrome de hipersensibilidad del seno carotídeo asociado a neoplasia cervical

We'd like to understand how you use our websites in order to improve them. Register your interest. Syncope associated with head and neck cancer is a rare and constitutes a special case of cardiovascular reflex. Three types of syndrome have been described: syndrome of carotid sinus hypersensitivity, syncope associated with glossopharyngeal neuralgia, and syncope associated with lesion of the parapharyngeal space.


Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. DOI: Syncope associated with head and neck cancer is a rare and constitutes a special case of cardiovascular reflex. Three types of syndrome have been described: syndrome of carotid sinus hypersensitivity, syncope associated with glossopharyngeal neuralgia, and syncope associated with lesion of the parapharyngeal space. We report a case of syncope in a patient with metastatic cervical adenopathy located in the carotid bifurcation, and secondary to laryngeal cancer.

Related Articles