Nasal carcinoma--a rare indication for a permanent pacemaker

Cardiac sinus syncope is a recognised but rare complication of head and neck cancers. Although electrical pacing remains an important treatment to prevent further syncopal episodes related to bradycardia, vasopressor-related syncope remains a more difficult management problem. The article describes the case of a 66-year-old patient with metastatic squamous cell carcinoma of the nose, who presented with syncope and exhibited carotid sinus syncope related to both carotid body invasion and vasopressor mechanisms. Successful management by the insertion of a permanent pacemaker is described, and a review of the literature on this rare complication is given.