What is Carotid Sinus Syndrome?

Carotid Sinus syndrome is a result of dilation or widening of the internal carotid artery and is also known as a carotid bulb indicating the swelling of the artery at a particular point or collar syndrome as the carotid sinuses are located near the neck where ones collar would sit.

The Carotid Artery consists of many sensitive receptors and nerve endings which monitor pressure.

During this syndrome the carotid sinus artery may become very sensitive to any form of stimulation and as a result can affect heart rate, amount of blood reaching the brain and blood pressure. This is known as CSH or Carotid Sinus Hypersensitivity. In severe cases a loss of consciousness or convulsions and seizers may occur when a build up of pressure occurs in these arteries due to manual stimulation. When the Carotid Sinus artery is compressed no blood flows to the cerebellum resulting in brain damage and death if the artery is not opened within a specific period of time.

Carotid sinus syndrome is more prevalent in the elderly generation and predominantly affects those over the age of 50. Males are also more prone to developing this condition.

What is Carotid Sinus Reflex?

Blood pressure balance and homeostatic balance are the two major functions of the carotid sinus reflex found in the Carotid artery. When this artery is over stimulated due to massages or pressure in this area, impulses are sent which affects normal blood pressure levels and heart beat (bradycardia). Vasodilatation or the increasing in arterial circumference and light headedness, dizziness and disorientation may also occur.

It is for this reason that one who suffers with Carotid sinus hypersensitivity should be careful even during mild stimulation of the neck area.

What are the causes of Carotid Sinus Hypersensitivity?

• Gender - Males are more likely to develop Carotid Sinus Hypersensitivity
• A sudden feeling of dizziness or disorientation when one stands up quickly. This is known as orthostatic hypotension and is a result of low blood pressure at the particular time when one stands up from a sitting position.
• Age related - The chances of one developing this condition increase with age
• The presence of plague or coronary artery disease or heart disease can make one more susceptible to Carotid Sinus Hypersensitivity.
• Tumours in the head or neck region
• The presence of high blood pressure
• Certain medications can make ones Carotid Sinus more sensitive. These include Beta-blockers and methyldopa

What are the symptoms of Carotid Sinus Syndrome?

• Frequent dizzy spells
• Low blood pressure
• A loss of muscle tone at times due to a decrease in heart beat and blood reaching the muscles.
• Excessive scarring in the neck region due to a trauma or the development of fibrosis and neck tumours in this area.
• Flat lining or having no heartbeat for a period of time.
• Forgetfulness or amnesia after an event which leaves one unconscious
• A slow heart beat or one that beats under 60 beats per minute
• Sudden falls which can result in injuries and fractures in elderly clients.
• Sudden death or strokes
• Carotid sinus reflex death is a result of vagus nerve impulses which may cause the heart to stop beating, i.e. cardiac arrest. This occurs during strangulation.

Please take note, in many cases a person may be completely symptom free or asymptomatic and still have CSH (Carotid Sinus Hypersensitivity). 

Diagnosis of Carotid Sinus Syndrome or Carotid Sinus Hypersensitivity

This condition is often diagnosed by a GP or Doctor when one experiences unexplained dizziness and disorientation.

The GP or Doctor can also use massage techniques in the neck region whilst monitoring any drop or fall in blood pressure. The possibility of Cardiac arrest should also be monitored. 

Treatments for Carotid Sinus Syndrome include-

• Denervation surgery is a procedure which helps prevent nerve impulse responsiveness and conductivity.
• Endarterectomy is a surgical procedure which helps remove plaque or plaque build-up in the arteries. If this plaque becomes dislodged it can get stuck in narrow arteries causing a blockage and prevention of blood flow in this area.
• Medications such as Heparin, Asprin and Plavix are recommended to prevent blood clotting and thickening of blood. These are known as anticoagulants. 

Tips for living with Carotid Sinus Syndrome of Carotid Sinus 
  Hypersensitivity

• Avoid massaging of the carotid sinus – This can be very dangerous as any massaging to this area can cause a thrombus or plaque to become dislodged resulting in it flowing freely through the arteries with a possibility of becoming lodged in a narrow artery and resulting in strokes and even death.
• Avoid wearing tight fitting collars.
• Try decrease the speed at which you turn your head
• Be extra gently when shaving over this artery as not to over stimulate it