Carotis-Sinus-Massage – Wer darf sie anwenden?

Zusammenfassung

Obwohl die Carotis-Sinus-Massage (CSM) zum Grundwissen eines jeden Internisten gehören sollte, gibt es keine allgemeingültige und strukturierte Anleitung zur Art der Durchführung und Anwendung. Wir analysierten die vorhandenen Leitlinien und existierende Literatur vor dem Hintergrund, wer darf die CSM wann durchführen. Zusammenfassend gibt es zwei Indikationen für eine CSM: Im Rahmen einer Synkopenabklärung sollte die CSM nur von einem erfahrenen Arzt unter EKG-Schreibung nach Ausschluss einer Atherosklerose der Carotis durchgeführt werden. Im Rahmen einer supraventrikulären Tachykardie darf vor dem Einsatz von medikamentösen Maßnahmen zur Terminierung der Tachykardie eine CSM von jedem angeleiteten Arzt bereits in der Notaufnahme durchgeführt werden ohne vorherige apparative Carotisdiagnostik.

Abstract

Although carotid sinus massage (CSM) belongs to the basic knowledge of every physician, there are no universally valid and structured guidance on the nature of the implementation and application. We analyzed the existing guidelines and literature in light of who is allowed to perform CSM. In summary, there are two indications for CSM: As part of diagnostic tools to clarify underlying pathology of syncope CSM should be performed only by an experienced physician with ECG control and after sonographic exclusion of carotid atherosclerosis if no other explanations are reasonable. In case of supraventricular tachycardia CSM may be used by any physician without prior sonography of the carotids to terminate the tachycardia before any pharmacological strategies are performed.

Schlüsselwörter

Carotis-Sinus-Massage - Synkope - Tachykardie

Keywords

carotid sinus massage - syncope - tachycardy

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