Internal Medicine

0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:13

760 Hypersensitive Carotid Syndrome and Syncope Hypertension

symptoms) in systolic pressure for abnormal vasodepressor

response.

➣Abnormal response may occur in normal subjects.

■Specific Diagnostic Test

➣see above.

differential diagnosis

■Syncope from other causes

management

What to Do First

■No acute intervention.

General Measures

■Avoidance of maneuvers leading to carotid stimulation.

specific therapy

■Dual chamber or ventricular pacemaker implantation, most effec-

tive for cardioinhibitory response.

■Elastic support hose and sodium retaining drugs have some but lim-

ited effect for vasodepressor response.

Side Effects & Contraindications

■Excessive fluid retention with sodium retaining drugs

follow-up

■Monitoring of recurrence of syncope. Pacemaker follow-up after

implantation

complications and prognosis

■Survival related to underlying diseases, not altered by pacemaker

implantation.

Hypertension.......................................

JOHN R. TEERLINK, MD

history & physical

[see also Chobanian AV, et al. The Seventh Report of the Joint

National Committee on Prevention, Detection, Evaluation, and Treat-

ment of High Blood Pressure: the JNC 7 report. JAMA. 2003 May

21;289(19):2560–72; European Society of Hypertension – European

Society of Cardiology Guidelines Committee. 2003 European Society of