- exaggerated response to carotid sinus stimulation
- diagnosis is made after ischemic heart disease and rhythm disturbance is excluded
- CSH may be predominantly cardioinhibitory (resulting in bradycardia), vasodepressor (resulting in hypotension) or mixture of both
- presents with recurrent dizziness, near syncope, syncope, unexplained falls (drop attacks), symptoms produced when wearing tight-fitting collar clothes or when taking carotid pulse
- cardioinhibitory CSH is managed with insertion of dual-chamber pacemaker and vasodilatory CSH is managed with support stocking, fludrocortisone and midodrine (alpha-1 agonist)
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