ABSTRACT
In spite of an intact pacemaker function, 3.8% of 444 patients with an implanted cardiac pacemaker taking part in a regular follow-up program had repetitive syncopes. The investigation thereafter, whether or not these attacks were symptoms of occlusive vascular disease of the carotid arteries, included a thorough physical and angiological examination, ophthalmodynamometry (ODM), ophthalmodynamography (ODG), and radionuclide angiography. The results were compared to those of a group of 46 cardiac pacemaker patients without syncopes after the implantation of the pacemaker: 29% of the patients with syncopes and 15% of the patients without syncopes showed ODM-, ODG-, and radionuclide angiography results compatible with carotid artery insufficiency; statistically, however, the group differences were insignificant. The reasons are discussed why ODM, ODG, and radionuclide angiography appear to be ineffective for the diagnosis of carotid artery occlusion in patients with an implanted cardiac pacemaker.
Subject(s)
Cardiac Pacing, Artificial , Aged , Arterial Occlusive Diseases/complications , Brain/diagnostic imaging , Carotid Artery Diseases/complications , Female , Humans , Male , Ophthalmodynamometry , Radionuclide Imaging , Recurrence , Syncope/diagnosis , Syncope/diagnostic imaging , Syncope/etiologyABSTRACT
A case of occlusion of the right common carotid artery combined with stenosis of the left common carotid artery is reported. Immediately after surgery a carotico-cavernosus fistula was observed on the right side. The clinical picture and the therapeutical problems are discussed; 4 X-ray and 2 fundus photographs are presented.
