EMERGENCY CASEBOOKS
Carotid sinus massage: is it a safe way to terminate supraventricular tachycardia?
Department of Emergency Medicine, Poole Hospital, Poole, UK
Correspondence to:
Dr H Adlington, Department of Emergency Medicine, Poole Hospital, Poole BH15 2JB, UK; harryadlington{at}yahoo.co.uk
A 63-year-old women with a history of palpitations presented to the emergency department with a supraventricular tachycardia; the patient was cardiovascularly stable. Carotid sinus massage (CSM) was performed to help identify the underlying rhythm. During massage the patient had an immediate cerebrovascular accident, resulting in a left hemiplegia. Given the prevalence of atherosclerotic vascular disease in the general population and the safe alternatives available, it is recommended that CSM not be used for the termination of narrow complex tachycardia in the elderly population.
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