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Carotid Sinus Hypersensitivity — RACP Adult Medicine MCQ

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ModerateCardiologyCarotid Sinus HypersensitivityRACP Adult Medicine

A 68-year-old man presents with syncope while shaving. He reports a brief loss of consciousness preceded by lightheadedness. There was no post-ictal confusion. He recovered within seconds. BP lying 130/80 mmHg, standing 128/78 mmHg. ECG is normal. What is the most likely cause of syncope?

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Correct answer: E — Carotid sinus hypersensitivity

Syncope triggered by head turning, neck pressure, or shaving in an elderly man is classic for carotid sinus hypersensitivity. The cardioinhibitory type (predominant bradycardia) is most common. Diagnosis is confirmed by carotid sinus massage under continuous monitoring. Treatment for symptomatic CSH with significant pauses is dual-chamber pacemaker insertion.

Reference: ESC – 2018 – Syncope Guidelines; eTG Cardiovascular 2024