title: [Role of body position during the carotid sinus stimulation test in the diagnosis of cardio-inhibitory carotid sinus syndrome].
abstract: The effect of body position during carotid sinus massage (CSM) for diagnosis of carotid sinus syndrome (CSS) of the cardioinhibitory type (CI) is not yet defined in the literature. The diagnosis of CSS-CI was made in 17 patients, the age range was 54 to 87 years (mean 74,7) on the basis of the following criteria: --history of recurrent syncope; --reproduction of symptoms during CSM repeated in different days in the presence of ventricular asystole that lasted more than 3 seconds; --absence of a vasodepressor reflex capable of producing symptoms, after a CI reflex was abolished by intravenous atropine; the blood pressure drop never exceeded 40 mmHg; --exclusion of other causes of syncope. In every patient the CSM was made in the supine position. If the test results were normal or left diagnostic doubts, the CSM was performed again in the standing position. Three different groups of patients were identified: a) normal result in the supine position, abnormal result in the standing position (cases 1 through 6); b) abnormal response both in the supine and in the standing position (7 and 8); c) abnormal response in the supine position, normal result in the standing position (9 and 10). In the cases 11 through 17 the CSM was not performed in the standing position because it was sufficiently diagnostic in the supine position. It is concluded that in the 35% of cases (6 of 17) the diagnosis of CSS-CI was obtained only after CSM was performed on the standing patient. In 53% of cases (9 of 17) the diagnosis was defined by CSM in supine position.(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial; D002340:Carotid Artery Diseases / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D013577:Syndrome
vernacular_title: Ruolo della postura durante massaggio del seno carotideo per la diagnosi di sindrome del seno carotideo cardio-inibitrice.