Research Article

Vasodepressor carotid sinus syncope.

Br Med J (Clin Res Ed) 1984; 289 doi: https://doi.org/10.1136/bmj.289.6447.720 (Published 22 September 1984) Cite this as: Br Med J (Clin Res Ed) 1984;289:720
  1. T Rentmeester,
  2. J Van Zile,
  3. M Van Hal,
  4. D Levene

    Abstract

    There have been few reports of vasodepressor carotid sinus syncope, as opposed to the cardioinhibitory type, and no definitive treatment has been described. A 58 year old man developed episodes of syncope after surgery and radiotherapy for a laryngeal tumour. The episodes were characterised by hypotension, sharp pain in the right neck, dizziness, and bradycardia. A temporary pacemaker failed to prevent the symptoms, but ephedrine and fludrocortisone produced substantial improvement. Of the four types of treatment used in carotid sinus syncope, irradiation was ruled out because the patient had had irradiation before developing syncope, surgery was inappropriate because of the laryngeal tumour, and pacing failed. Combined drug treatment with a vasoconstrictor and plasma volume expander produced an improvement in symptoms but did not eliminate them.