The Carotid Sinus

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Abstract
The carotid sinuses, situated at the bifurcation of the common carotid arteries, are important pressoreceptors. They are activated by changes in pulsatile intravascular pressure, thereby initiating reflexes that modify heart rate, cardiac output, blood pressure, peripheral resistance, and venomotor tone, as well as pulmonary blood flow and ventilation. Their superficial location in the neck permits ready manipulation and influence upon the heart and peripheral vessels. Massage of the carotid sinus, when a few simple precautions are heeded, is a procedure devoid of serious hazard. This procedure had been much neglected. At times it affords the only means of establishing a definite diagnosis. Often it provides invaluable clues for diagnosis of various heart conditions and frequently serves as a definite therapeutic procedure. Carotid sinus stimulation is of value in diagnosis, treatment, or analysis of the following arrhythmias of the heart, angina pectoris, coronary artery disease, acute pulmonary edema, bundle-branch block, and the state of digitalization. Increased sensitivity of the carotid sinuses may evoke reflexes that seriously impair heart rate, peripheral resistance, or both, and may thereby precipitate syncopal episodes.