CASE REPORT: PDF OnlyRecurrent Syncope Due to Carotid Sinus Hypersensitivity and Sick Sinus SyndromeKuo, Feng-Yua; Hsiao, Hsiang-Chianga; Chiou, Chuen-Wanga, b; Liu, Chun-Penga, b, *Author Information aCardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung bNational Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C. *Correspondence to: Dr Chun-Peng Liu, Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, 386, Dar-Chung 1st Road, Kaohsiung 813, Taiwan, R.O.C. E-mail: [email protected] Received: August 6, 2007; • Accepted: May 16, 2008. Journal of the Chinese Medical Association: October 2008 - Volume 71 - Issue 10 - p 532-535 doi: 10.1016/S1726-4901(08)70163-1 Metrics Abstract Syncope is a sudden and brief loss of consciousness with postural tone. Its recovery is usually spontaneous. There are various causes of syncope including cardiac, vascular, neurologic, metabolic and miscellaneous origins. The tracing is usually time-consuming and costly. The diagnosis of carotid sinus syncope may sometimes be difficult since the symptoms are nonspecific, especially in older persons. Here, we report the case of a 72-year-old woman who sought medical attention at our hospital due to repeated syncope episodes over the previous 5 years. Neurologic examinations showed negative results (including brain computed tomography). Twenty-four-hour ambulatory electrocardiogram monitoring showed atrial and ventricular premature contractions only. Electrophysiologic study disclosed prolonged corrected sinus node recovery time (1,737 ms) with poor atrioventricular conduction. Drop of blood pressure together with sinus bradycardia developed after left side carotid sinus massage. Both carotid sinus hypersensitivity with sick sinus syndrome contributed to this patient's syncope, and after pacemaker placement together with selective serotonin reuptake inhibitor treatment, she was free from syncope thereafter. © 2008 by Lippincott Williams & Wilkins, Inc.