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Carotid sinus syncope is due to pressure on the carotid sinus in the neck. [2] The underlying mechanism involves the nervous system slowing the heart rate and dilating blood vessels, resulting in low blood pressure and thus not enough blood flow to the brain. [2] Diagnosis is based on the symptoms after ruling out other possible causes. [3]
Neurally mediated syncope may also occur when an area in the neck known as the carotid sinus is pressed. [1] A normal response to carotid sinus massage is reduction in blood pressure and slowing of the heart rate. Especially in people with hypersensitive carotid sinus syndrome this response can cause syncope or presyncope. [9]
The carotid sinus baroreceptor can be oversensitive to manual stimulation from the pressure applied at the carotid sinus at the carotid bifurcation. It is a condition known as 'carotid sinus hypersensitivity' (CSH), 'carotid sinus syndrome' or 'carotid sinus syncope', in which manual stimulation causes large changes in heart rate and blood ...
He further observed and documented that the turbinates in the dependent nasal fossa fill when the patient is lying down. The nasal cycle is an alternation in both time and between left and right sides, with the total resistance in the nose remaining constant. The asymmetric airflow may have some benefit to overall olfactory sensitivity. [6]
A clinical photograph showing a patient with the flexed posture. It can be abated when lying down. [1]Camptocormia, also known as bent spine syndrome (BSS), is a symptom of a multitude of diseases that is most commonly seen in the elderly.
The pressure difference causes the mucosal lining of the sinuses to become swollen and submucosal bleeding follows with further difficulties ventilating the sinus, especially if the orifices are involved. Ultimately fluid or blood will fill the space. In most cases of sinus barotrauma, localized pain to the frontal area is the predominant symptom.
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In addition, patulous Eustachian tube generally feels dry with no clogged feeling or sinus pressure. Patients hear their own voice or its echo from inside. [3] [4] They describe it as being amplified and unpleasant. Lying head down may help since it increases venous blood pressure and congestion of the mucosa.