Kenny et al listed a number of contraindications to performing carotid sinus massage. The authors are from the Royal Victoria Infirmary in Newcastle Upon Tyne.


Evaluation: The carotid artery is auscultated for bruits prior to sinus massage. If a bruit is heard over the carotid artery, then Doppler ultrasonography (US) is performed.


Contraindications to carotid sinus massage:

(1) history of myocardial infarction within the past 3 months

(2) history of transient ischemia attack or stroke within the past 3 months

(3) history of a previous serious adverse response to carotid sinus massage

(4) carotid artery stenosis on ultrasonography > 70%


If carotid artery stenosis is 50 to 70%, then carotid artery massage is only performed with the patient supine.


Additional reasons to avoid carotid sinus massage (not listed in paper):

(1) recent carotid artery surgery on that side

(2) abscess adjacent to carotid sinus


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