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Vagal maneuvers (most commonly the Valsalva maneuver) can be used to distinguish between ventricular tachycardia and supraventricular tachycardia by slowing the rate of conduction at the SA or AV nodes. [1] Vagal maneuvers (most commonly carotid sinus massage) are used to diagnose carotid sinus hypersensitivity. [2] Therapeutic:
The Czermak–Hering test is a vagal maneuver consisting of the application of external digital pressure to the carotid sinus. [1] The test is performed at the patient's bedside by imposing moderate pressure with the fingers, repeatedly massaging the left or the right carotid arteries .
These manoeuvres include carotid sinus massage (pressure on the carotid sinus in the neck) and the Valsalva manoeuvre (increasing the pressure in the chest by attempting to exhale against a closed airway by bearing down or holding one's breath).
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Sinus tachycardia is a normal response to physical exercise or other stress, when the heart rate increases to meet the body's higher demand for energy and oxygen, but sinus tachycardia can also be caused by a health problem. [4] An elite athlete's heart recorded during a maximum effort workout maintaining over 180 bpm for 10 minutes.
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 ...
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]