What is Carotid Sinus?

The internal carotid artery originates at the common carotid artery's bifurcation and a localized dilation at this point is what is called the carotid sinus. Its main function is to act as a sampling area through a large number of baroreceptors for homeostatic mechanism to maintain blood pressure. A particular nerve of the sinus called Hering innervates the baroreceptors in the carotid sinus. This sinus sometimes gets atherosclerotic plaques. This is caused by hemodynamics. Hemodynamics is the medical term used for low wall shear stress inducing flow reversal or recirculation.

Now what causes carotid sinus related diseases is nothing but these very plaques. If these plaques are large and therefore unstable, they make a person susceptible to ischemic strokes and also transient ischemic attacks.

To understand a bit more about what carotid sinus and human stimulation are related we need to look into what is what is carotid sinus reflex death. This is actually a disputed mechanism which is supposed to cause death through manual stimulation of the carotid sinus. this happens because strong very strong vagus nerve impulses are generated which leads to terminal cardiac arrest. This is supposedly the cause of death in cases of strangulation and hanging. However this is still controversial even though studies point out that if not the main or only cause but still this can be a very significant factor in death as it reduces both blood pressure and heart rate. This is more true in case of elderly people and people suffering from hypersensitivity of carotid sinus. The other life threatening effects produced by the hypersensitivity of carotid sinus besides heart attack are pulmonary embolism and stroke.

One very interesting fact, which comes handy in dealing with some of the problems, is what is called as carotid sinus hypersensitivity itself! It is oversensitive to manual stimulation and manual stimulation can effect substantial changes in blood pressure and heart rate. Massage is used many times in diagnosing carotid sinus syncope. This is also used differentiating between supraventricular tachycardia and ventricular tachycardia. Though it is not as effective as pharmaceutical management is with adenosine or verapmil.

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