Case Report: Carotid Sinus Hypersensitivity During Internal Jugular Venous Cannulation
DOI:
https://doi.org/10.12970/2311-052X.2016.04.01.1Keywords:
Robotic-assisted gait training, robotics. neurodegenerative disease, Parkinson’s disease, multiple sclerosis, progressive supranuclear palsy, gait.Abstract
Carotid sinus hypersensitivity is common in elderly patients. Baroreceptor function generally decreases with age but some people experience hypersensitive carotid baroreflexes. In such individuals, even mild stimulation to the neck results in profound bradycardia and hypotension. In this case, CSH was elicited during internal jugular venous cannulation which is a common procedure in cardiac surgery. Knowledge about CSH can help us to take appropriate precautions in perioperative period and manage cardiac instability arising from this reflex. Keywords: Carotid sinus hypersensitivity, baroreceptor, bradycardia, hypotension, internal jugular vein, syncope, atrio-ventricular pacing.
References
Strasberg B, Sagie A, Erdman S, Kusniec J, Sclarovsky S, Agmon J. Carotid sinus hypersensitivity and the carotid sinus syndrome. Prog Cardiovasc Dis 1989; 31: 379-91. http://dx.doi.org/10.1016/0033-0620(89)90032-7
Thomas JE. Diseases of the carotid sinus - syncope. In: Vinken PJ, Bruyn GW, eds. Handbook ofClinical Neurology, vol 11, chap 19. Amsterdam: North Holland Publishing 1972: 532-51.
Nathanson MH. Hyperactive cardioinhibitory carotid sinus reflex. Arch Intern Med 1946; 77: 491-503. http://dx.doi.org/10.1001/archinte.1946.00210400016002
McIntosh SJ, Lawson J, Kenny RA. Clinical characteristics of vasodepressor, cardioinhibitory, and mixed carotid sinus syndrome in the elderly. Am J Med 1993; 95(2): 203-8. http://dx.doi.org/10.1016/0002-9343(93)90261-M
O’Mahony D. Pathophysiology of carotid sinus hypersensitivity in elderly patients. Lancet 1995; 346(8980): 950-2. http://dx.doi.org/10.1016/S0140-6736(95)91563-X
Brignole M, Alboni P, Benditt DG, et al. Guidelines on management (diagnosis and treatment) of syncope-update 2004: executive summary. Eur Heart J 2004; 252054-2072.
Chung HS, Park CM, Kim ES, Ghil BG, Park CS. Temporary cardiac arrest in patient under robotically assisted total thyroidectomy causing carotid sinus hypersensitivity -A case report-. Korean J Anesthesiol 2010; 59(Suppl): S137-40. http://dx.doi.org/10.4097/kjae.2010.59.S.S137
Truong AT, Sturgis EM, Rozner MA, Truong DT. Recurrent episodes of asystole from carotid sinus hypersensitivity triggered by positioning for head and neck surgery. Head Neck 2011; [Epub ahead of print].
Morley CA, Sutton R. Carotid sinus syncope [Editorial]. Int J Cardiol 1984; 6: 287-93. http://dx.doi.org/10.1016/0167-5273(84)90188-8
Brignole M, Menozzi C, Lolli G, Bottoni N, Gaggioli G. Longterm outcome of paced and nonpaced patients with severe carotid sinus syndrome. Am J Cardiol 1992; 69: 1039-43. http://dx.doi.org/10.1016/0002-9149(92)90860-2
Morley CA, Perrins EJ, Grant P, Chan SL, McBrien DJ, Sutton R. Carotid sinus syncope treated by pacing. Analysis of persistent symptoms and role of atrioventricular sequential pacing. Br Heart J 1982; 47: 411-18. http://dx.doi.org/10.1136/hrt.47.5.411
