Orthostatic hypotension improved after bilateral carotid endarterectomy--case report

A 60-year-old male with recurrent syncopal attacks presented with orthostatic hypotension on the head-up tilt test. Angiography also showed severe stenosis of the bilateral extracranial carotid arteries. He underwent two-staged bilateral carotid endarterectomy. After the operations, the orthostatic hypotension resolved and the syncopal attacks have disappeared completely. Orthostatic hypotension in this patient was due to vasodepressor-type carotid sinus syndrome caused by compression of the carotid baroreceptors by atherosclerotic plaques.