Ischemic Stroke Occurring After Supraventricular Dysrhythmia Conversion With Carotid Massage: A Case Report.
Josephine Raun Henriksen, Hanne Nygaard, Rasmus Gregersen Mottlau
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Case in brief
A 67-year-old woman presented with acute chest pain, dizziness, and palpitations, with a heart rate of 234 bpm. After unsuccessful vagal maneuvers and carotid sinus massage, adenosine restored her sinus rhythm. However, within 30 minutes, she developed right-sided hemiparesis and transcortical motor aphasia. Imaging confirmed a left Middle Cerebral Artery territory infarction, and she was discharged 2 days later with minor residual deficits.
What made this case unusual
This case highlights the occurrence of ischemic stroke following carotid sinus massage performed in a controlled hospital setting, which is rarely reported.
Diagnostic / clinical pearl
Clinicians should be aware of the potential risk of ischemic stroke associated with carotid sinus massage during the management of supraventricular tachycardia.
Why it matters
This case underscores the need for further investigation into the safety of carotid sinus massage, particularly regarding its potential to cause thromboembolic events.