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Syncope caused by carotid body tumor
J Vincelj1, M Kirin, Z Borković
1Dubrava University Hospital, Zagreb, Croatia.
Summary
Carotid body tumors can cause syncope (fainting) due to heart pauses. Surgical removal of the tumor successfully treated the patient, highlighting the importance of temporary pacing for such procedures.
Area of Science:
- Cardiology
- Neurosurgery
- Endocrinology
Background:
- Carotid body tumors are rare paragangliomas typically found at the carotid bifurcation.
- Syncope, or fainting, can be a rare presenting symptom of carotid body tumors, often linked to cardiovascular events.
- The mechanism involves potential mechanical compression or neural stimulation affecting cardiovascular reflexes.
Observation:
- A 71-year-old woman presented with syncope and a palpable left-sided neck mass, later diagnosed as a carotid body tumor.
- During examination, palpation of the tumor induced transient vertigo and syncope, accompanied by a significant 7.6-second asystolic pause on ECG.
- The patient underwent successful surgical resection of the carotid body tumor.
Findings:
- Post-surgery, manual stimulation of the neck area no longer elicited bradycardia or asystole, indicating the resolution of the causative factor.
- The patient experienced no further syncopal episodes and remained well one year after the procedure.
- ECG monitoring confirmed the absence of pathological pauses after tumor removal.
Implications:
- This case underscores carotid body tumors as a treatable, albeit rare, cause of syncope.
- Temporary pacemaker insertion is recommended for patients undergoing diagnostic or surgical interventions for carotid body tumors presenting with syncope.
- Successful surgical management can lead to complete resolution of symptoms and long-term recovery.