AI Article Synopsis
- Elderly patients often experience dizziness and syncope, but the cause may not always be clear.
- Three patients underwent carotid sinus massage, revealing carotid sinus syndrome (CSS), which can cause severe drops in blood pressure and heart rate.
- Instead of the usual pacemaker treatment, these patients had successful surgery to remove layers from the internal carotid artery, leading to symptom relief, highlighting the importance of considering CSS in dizzy elderly patients.
Article Abstract
Elderly patients frequently suffer from dizziness and syncope; however, an underlying disease may not always be identified. Three patients aged 69, 71 and 56, respectively, experienced spells of dizziness and syncope. Massage of the carotid sinus demonstrated the presence of a carotid sinus syndrome (CSS), an abnormal baroreflex response of the carotid sinus that leads to asystole and extreme hypotension. Conventional treatment is generally by insertion of a pacemaker. These patients, however, were referred to the vascular surgery department of our hospital for removal of adventitial layers of proximal portions of the internal carotid artery. Recovery was uneventful; all three are now free of symptoms. CSS should be considered in the differential diagnosis of dizziness and syncope. Surgical denervation of the carotid artery is a valid treatment option, especially in the vasodepressive or mixed type of CSS.
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