{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T10:26:19Z","timestamp":1761647179266},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"897","license":[{"start":{"date-parts":[[2000,7,1]],"date-time":"2000-07-01T00:00:00Z","timestamp":962409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Carotid sinus syndrome (CSS) and neurocardiogenic syncope (NCS) are recognised as important causes of recurrent syncope and falls in the elderly. In this study the role of CSS (diagnosed with carotid sinus massage) and NCS (diagnosed with prolonged head-up tilt) in a district general hospital were investigated.<\/jats:p>\n               <jats:p>Over 27 consecutive months carotid sinus massage was performed in 139 patients. Of these 29 (20.8%) patients (mean (SD) age of 78 (9) years) showed a positive response. Of these 18 (62%) patients showed a positive response only when carotid sinus massage was performed with 70\u00b0 head-up tilt.<\/jats:p>\n               <jats:p>Thirteen (8.7%) of the 149 patients who had prolonged head-up tilt testing were found to have NCS. The mean (SD) age for patients with NCS was 59 (26) years and the mean (SD) time required to produce a positive response during prolonged head-up tilt was 12 (5) minutes.<\/jats:p>\n               <jats:p>It is concluded that carotid sinus massage and head-up tilt testing are useful in patients presenting with unexplained syncope and falls in a district general hospital setting. Carotid sinus massage should be repeated upon head-up tilt if a negative response is obtained in the supine position.<\/jats:p>","DOI":"10.1136\/pmj.76.897.405","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T10:38:40Z","timestamp":1027766320000},"page":"405-408","source":"Crossref","is-referenced-by-count":7,"title":["Role of carotid sinus syndrome and neurocardiogenic syncope in recurrent syncope and falls in patients referred to an outpatient clinic in a district general hospital"],"prefix":"10.1093","volume":"76","author":[{"given":"Abuzeid","family":"Eltrafi","sequence":"first","affiliation":[{"name":"Wirral Hospital, Merseyside, UK: Department of Geriatric Medicine , Merseyside, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debra","family":"King","sequence":"additional","affiliation":[{"name":"Wirral Hospital, Merseyside, UK: Department of Geriatric Medicine , Merseyside, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph H","family":"Silas","sequence":"additional","affiliation":[{"name":"Department of Cardiology , Merseyside, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Currie","sequence":"additional","affiliation":[{"name":"Department of Cardiology , Merseyside, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Lye","sequence":"additional","affiliation":[{"name":"University of Liverpool , Merseyside, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2000,7,1]]},"reference":[{"key":"2023042614123438100_B1","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1093\/ageing\/20.6.449","article-title":"Carotid sinus syndrome\u2014clinical characteristics in elderly patients.","volume":"20","author":"Kenny","year":"1991","journal-title":"Age Ageing"},{"key":"2023042614123438100_B2","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1016\/0002-8703(94)90395-6","article-title":"Vasovagal syncope as a cause of motor vehicle accidents.","volume":"127","author":"Decter","year":"1994","journal-title":"Am Heart J"},{"key":"2023042614123438100_B3","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/0002-9149(78)90934-7","article-title":"Carotid sinus hypersensitivity and syncope.","volume":"42","author":"Walter","year":"1978","journal-title":"Am J Cardiol"},{"key":"2023042614123438100_B4","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1056\/NEJM198307283090401","article-title":"A prospective evaluation and follow-up of patients with syncope.","volume":"309","author":"Kapoor","year":"1983","journal-title":"N Engl J Med"},{"key":"2023042614123438100_B5","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1093\/ageing\/22.1.53","article-title":"Benefits of an integrated approach to the investigation of dizziness, falls and syncope in elderly patients referred to a syncope clinic.","volume":"22","author":"McIntosh","year":"1993","journal-title":"Age Ageing"},{"key":"2023042614123438100_B6","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1016\/S0140-6736(86)91665-X","article-title":"Head-up tilt: a useful test for investigating unexplained syncope.","volume":"i","author":"Kenny","year":"1986","journal-title":"Lancet"},{"key":"2023042614123438100_B7","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/S0735-1097(83)80014-X","article-title":"The Bezold-Jarish reflex revisited: clinical implications of inhibitory reflexes originating in the heart.","volume":"1","author":"Mark","year":"1983","journal-title":"J Am Cardiol"},{"key":"2023042614123438100_B8","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1097\/00001573-199601000-00006","article-title":"Current trends in aetiology, diagnosis and management of neurocardiogenic syncope.","volume":"11","author":"Grubb","year":"1996","journal-title":"Curr Opin Cardiol"},{"key":"2023042614123438100_B9","first-page":"507","article-title":"Syncope: pathophysiology and differential diagnosis.","volume-title":"The heart.","author":"Weissler","year":"1986"},{"key":"2023042614123438100_B10","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1093\/ageing\/22.1.53","article-title":"Outcome of an integrated approach to the investigation of dizziness, falls and syncope in elderly patients referred to a syncope clinic.","volume":"22","author":"McIntosh","year":"1993","journal-title":"Age Ageing"},{"key":"2023042614123438100_B11","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1136\/bmj.283.6301.1217","article-title":"Fractured neck of femur. 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