Such a life-saving technique so easily explained in laymen's terms (all the while educating us with medical terminology) that most can learn, put in their back pocket to pull out when a possible emergency arises. Thank you! ♥️
Two things.. 1. This maneuver will not cardiovert atrial fibrillation or atrial flutter, these rhythms arise from local (intracardiac) signals , not centrally (autonomic system). 2. I was under the impression that carotid massage is to directly massage the carotid sinus, which is rich in baroceptors (pressure receptors) to create the illusion of intracranial hypertension , thus a reflexive bradycardia should ensure (in theory). The 'valsalva' maneuver is similar in its effect, but does so by reducing jugular venous flow (blood out of the cranial vault) and actually producing a transient intracranial hypertension.
Thank you! I frequently have SVT's. While I've known about carotid sinus massage for quite a while, I've never been able to get it right until I saw your video, SVTs' are very uncomfortable, especially when they last a long time. Thank you again! I am most grateful!
@@aimer2815 If there's any atherosclerosis present in the carotids (likely in high-risk stroke patients), there is an increased risk of embolism with the atherosclerotic clot traveling up to the brain causing ischemic infarct and ultimately resulting in stroke.
Med student aside: the carotid afferent signal is carried by the glossopharyngeal nerve, not the vagus. The efferent signal to the heart is carried by the vagus. Also, before doing this procedure listen with the stethoscope for bruits. This procedure can otherwise dislodge atherosclerotic plaque and stroke your patient. You can also simply massage the carotid itself, which will increase the blood pressure in the carotid, and accomplish the same task.
I was under the impression that the information was CN IX based, but traveled in vagal fibers. I know it is splitting hairs and most of this is highly variable anyways.*****
Only under controlled situations (in an operating room, with the plaque held onto by devices). If you just release the plaque, it will course directly to your brain, occlude blood flow, and give you a stroke. It's quite a bad thing to dislodge it.
I tried this, watched my heart rate on the fitbit app, it did not change (it even went up by 3-4 bpm at one point). Assuming I did this correctly, why did my heart rate not decrease?
I have PSVT, had plenty of episodes. Vagel manouver has worked but if I can catch an episode just as it starts and Im very aware of my heart these days. I go right for the carotid pulse and hold it for 5 seconds or so. The pushing on the artery seems to raise my BP enough for my vagel nerve to lower my pulse back down to normal or closer to normal right away. I avoid going into a full blown svt episode. Its worked very well last 3 or so episodes. I avoid the episode that might need me to take medication a blocker, or avoid ending up in the ER which has happend 2X.
Cannot believe how many people are so scared of doing this massage due to a possible loss of circulation to the brain when Jiu Jitsu athletes are choked out daily. Calm down. Do the massage and relax. No ones dying.
M3 here- loss of circulation to the brain is what causes you to pass out or experience syncope. The term you are referring to as being "choked out" is temporarily cutting blood supply off to your brain which is quite dangerous. If you do the carotid massage bilaterally depending on: the patients past medical history, age, level of coronary artery disease, medications they're on you can induce syncope and even cause them to faint. Or even worse you can dislodge a carotid plaque and give the person a stroke even if you do it unilaterally. So yes there is an increased risk of injury or permanent damage when you occlude, massage or squeeze the major blood supply to the brain.
@@KR-ye8gv yeah i understand all d preventive warnings they try to give us. But i can't believe that a gentle massage can be as dangerous than a punch or a choke that wrestlers, boxers, fighters etc do on their performances. I mean as long as the patient is healthy i don't get why this sinus massage can be that risky. I know that these kind of fighters are proffessionals but they aren't doctors and they have the permission of cutting the blood vessels in so many ways (which i don't think they do it every time in the right way) of a person during a raw battle without taking responsability and if a doctors fails at doing a massage it could loose his job or worse? There's something fishy here...
Why go lateral once you find the pulse? The actual purpose of this exercise is to go above the carotid sinus and press the artery. This makes blood backup and creates a false high blood pressure in the sinus (where pressure is gauged). Then CN X and XI carry the signal up and CN X carries it back down. You need a lot more pressure to make someone pass out.
Exactly. I thought the purpose was to put mechanical pressure on the carotid body baroreceptors, sending a "fake signal" to relax vasculature/induce parasympathergic activity
Thanks for the expiation and great video. I did this same type of neck massaging by accident during an A-FIb attack a while back, and it stops my heart racing and restores my normal heart beat within 1-2 minutes every time! I am not sure what all the warning posts on the internet are talking about harming yourself with this, because I and probably every one else have been rubbing there necks from time to time for years. I guess you should only do one side at a time? Is that what they are saying?
M Jam We here at MSME recommend only doing 1 side at a time. There is a chance (albeit a small one) that your massaging is occluding the main arteries to your brain, and it's best to not block both of them at the same time. Hope that helps-
Completely agree with some of the posts below. This maneuver should only be done in the emergency department because although rare, it can induce sinus arrest! The patient will die if he or she slips into sinus arrest and there is no crash cart around to resuscitate them. [Thaler - 2015]
What do you mean by coughing and the sinus massage? Are you talking about the valsalva maneuver? A massage and coughing sound pretty different to me. Does a persons heart rate slow down when they cough?? Your response is so ambiguous, it doesn't help anybody.
Ok - should have qualified - when you cough forcefully. If you don't understand how the Valsalva works, and what physical acts induce it - I suggest some basic review. And yes, your heart rate does change during the Valsalva - again, basic physiology.
Hi, I have question that you might be able to answer: I have an undiagnosed condition and one symptom is that when I first lie down at bed at nights, my carotid artery at the right side pumps so forcefuly that it sometimes even hurts. Parallel to that, I hear pulse in my ears and feel pressure in my head. It also happens when I turn from one side to the other in bed. And what I discovered is, if I block the carotid artery with my fingers for a little while, the pulse noise and pressure feeling gets worse at first, but they disappear and don't come back the moment I let go of my hand! Do you have any idea why that happens?
it is possible you have valvular heart disease, maybe aortic regurgitation, lying down would increase the amount of blood in your venous system, which will increase the amount of blood going to your heart, with regurgitation you are already adding more blood to the heart to pump out so when combined with the regurg it can manifest as significant increase in systolic pressures which can translate to significant pressures in the carotids, also look into underlying connective tissue disease
It isn't just the possibility of passing out. I do this to stop my SVT episodes, but it does have some possible downsides. If you have fat/cholesterol deposit in your carotid artery, you can dislodge a piece of it, resulting in a stroke, maybe death.
Have you tried doing the modified Valsava Maneuver instead? It has a reasonably high level of success in the field and our Ambulance service do it for our SVT patients. The risks associated with it are lower than with carotid massage but it can still result in clot dislodgement and severe bradycardia, just less commonly than with the technique you are already using.
Valsalva didn't do anything for me. Since my previous post, I had another catheter ablation for WPW syndrome -- same spot as 17 years ago (i.e., they didn't quite fix it back then, but the fix did last 15 years). SVT is gone again.
i am having these symptoms ... pressure , tightness in my neck,i have fainted , but before i do , everything in my neck feel like it is pinching off, even my hearing , i think i am having issues with this nerve....
Med School Made Easy I massage my throat neck area before workouts and after as always think it will help blood flow to my brain,I also do this all over major arteries and organs in belieif that it will stir up the sedements in my system,might sound stupid to a doctor but I like believing my own ideas about health sometimes..
This is not safe to do yourself, might result into some serious complications. Let your doctor, who will take all the necessary precautions, do it for you if you need it.
Is it safe to do if your not having any heart issues. Like if your following along with the video and just learning. Because my first instinct was to follow along while he was doing it.
My fitness freak brother, who's also a health freak, received a similar massage and he lost consciousness inside the massage room. It triggered a Hemorrhagic Stroke.
Hi am deepu am from india I suffering from AVM on right upper eye lid a doctor suggest me dat my AVM is cured through caratod compression massage . It is high risk on embolization. doctor said?
I'm thinking he's a medic. There are a lot of risks. Carotid stenosis, risk of causing a stroke/TIA, etc. Please don't practice medicine, unless you're a doctor. I've worked with doctors that weren't comfortable doing it due to the patient's medical history.
![Kodak Black - Versatile 4 [Official Video]](http://i.ytimg.com/vi/VcP_1Ua__vY/mqdefault.jpg)
Such a life-saving technique so easily explained in laymen's terms (all the while educating us with medical terminology) that most can learn, put in their back pocket to pull out when a possible emergency arises. Thank you! ♥️
Two things.. 1. This maneuver will not cardiovert atrial fibrillation or atrial flutter, these rhythms arise from local (intracardiac) signals , not centrally (autonomic system). 2. I was under the impression that carotid massage is to directly massage the carotid sinus, which is rich in baroceptors (pressure receptors) to create the illusion of intracranial hypertension , thus a reflexive bradycardia should ensure (in theory). The 'valsalva' maneuver is similar in its effect, but does so by reducing jugular venous flow (blood out of the cranial vault) and actually producing a transient intracranial hypertension.
It could effectively give you a stoke if you have plaque build up.
Thank you! I frequently have SVT's. While I've known about carotid sinus massage for quite a while, I've never been able to get it right until I saw your video, SVTs' are very uncomfortable, especially when they last a long time. Thank you again! I am most grateful!
you're welcome!
It should be mentioned that this is contraindicated for high-risk stroke patients. Use discretion.
+Sam Hebert Excellent, thanks Sammo
But why
@@aimer2815 If there's any atherosclerosis present in the carotids (likely in high-risk stroke patients), there is an increased risk of embolism with the atherosclerotic clot traveling up to the brain causing ischemic infarct and ultimately resulting in stroke.
Med student aside: the carotid afferent signal is carried by the glossopharyngeal nerve, not the vagus. The efferent signal to the heart is carried by the vagus.
Also, before doing this procedure listen with the stethoscope for bruits. This procedure can otherwise dislodge atherosclerotic plaque and stroke your patient.
You can also simply massage the carotid itself, which will increase the blood pressure in the carotid, and accomplish the same task.
good stuff, thanks!
Good points. Auscultation has a terrible sensitivity for carotid stenosis btw
I was under the impression that the information was CN IX based, but traveled in vagal fibers. I know it is splitting hairs and most of this is highly variable anyways.*****
Danny I was under the impression that dislodging plaque was a good thing and that the system would dissolve it to someone extent ,can it ?
Only under controlled situations (in an operating room, with the plaque held onto by devices). If you just release the plaque, it will course directly to your brain, occlude blood flow, and give you a stroke.
It's quite a bad thing to dislodge it.
Nobody tells you about the lateral movement, this is great
I tried this, watched my heart rate on the fitbit app, it did not change (it even went up by 3-4 bpm at one point). Assuming I did this correctly, why did my heart rate not decrease?
I have PSVT, had plenty of episodes. Vagel manouver has worked but if I can catch an episode just as it starts and Im very aware of my heart these days. I go right for the carotid pulse and hold it for 5 seconds or so. The pushing on the artery seems to raise my BP enough for my vagel nerve to lower my pulse back down to normal or closer to normal right away. I avoid going into a full blown svt episode. Its worked very well last 3 or so episodes. I avoid the episode that might need me to take medication a blocker, or avoid ending up in the ER which has happend 2X.
Cannot believe how many people are so scared of doing this massage due to a possible loss of circulation to the brain when Jiu Jitsu athletes are choked out daily. Calm down. Do the massage and relax. No ones dying.
M3 here- loss of circulation to the brain is what causes you to pass out or experience syncope. The term you are referring to as being "choked out" is temporarily cutting blood supply off to your brain which is quite dangerous. If you do the carotid massage bilaterally depending on: the patients past medical history, age, level of coronary artery disease, medications they're on you can induce syncope and even cause them to faint. Or even worse you can dislodge a carotid plaque and give the person a stroke even if you do it unilaterally. So yes there is an increased risk of injury or permanent damage when you occlude, massage or squeeze the major blood supply to the brain.
@@KR-ye8gv yeah i understand all d preventive warnings they try to give us. But i can't believe that a gentle massage can be as dangerous than a punch or a choke that wrestlers, boxers, fighters etc do on their performances. I mean as long as the patient is healthy i don't get why this sinus massage can be that risky. I know that these kind of fighters are proffessionals but they aren't doctors and they have the permission of cutting the blood vessels in so many ways (which i don't think they do it every time in the right way) of a person during a raw battle without taking responsability and if a doctors fails at doing a massage it could loose his job or worse? There's something fishy here...
Why go lateral once you find the pulse? The actual purpose of this exercise is to go above the carotid sinus and press the artery. This makes blood backup and creates a false high blood pressure in the sinus (where pressure is gauged). Then CN X and XI carry the signal up and CN X carries it back down. You need a lot more pressure to make someone pass out.
Exactly. I thought the purpose was to put mechanical pressure on the carotid body baroreceptors, sending a "fake signal" to relax vasculature/induce parasympathergic activity
Thanks for the expiation and great video. I did this same type of neck massaging by accident during an A-FIb attack a while back, and it stops my heart racing and restores my normal heart beat within 1-2 minutes every time! I am not sure what all the warning posts on the internet are talking about harming yourself with this, because I and probably every one else have been rubbing there necks from time to time for years. I guess you should only do one side at a time? Is that what they are saying?
M Jam We here at MSME recommend only doing 1 side at a time. There is a chance (albeit a small one) that your massaging is occluding the main arteries to your brain, and it's best to not block both of them at the same time. Hope that helps-
I went to the E R last night with a tachycardia. The doctor did something very similar to this and my tachycardia stopped
Does it lower BP?
Completely agree with some of the posts below. This maneuver should only be done in the emergency department because although rare, it can induce sinus arrest! The patient will die if he or she slips into sinus arrest and there is no crash cart around to resuscitate them. [Thaler - 2015]
BS - you do this every time you cough.
What do you mean by coughing and the sinus massage? Are you talking about the valsalva maneuver? A massage and coughing sound pretty different to me. Does a persons heart rate slow down when they cough?? Your response is so ambiguous, it doesn't help anybody.
Ok - should have qualified - when you cough forcefully. If you don't understand how the Valsalva works, and what physical acts induce it - I suggest some basic review. And yes, your heart rate does change during the Valsalva - again, basic physiology.
Not right
Very rare
Awesome in that you taught it in a way that made it sound easy.
Carotid sinus massage will cause my heart to "chill out". haha love it.
M2 here. Thanks for the quick intro!
you rock Tyler
Awesomely informative and perfectly explained! Thank you so much! 😊😊 5/3/2019
Hi, I have question that you might be able to answer: I have an undiagnosed condition and one symptom is that when I first lie down at bed at nights, my carotid artery at the right side pumps so forcefuly that it sometimes even hurts. Parallel to that, I hear pulse in my ears and feel pressure in my head. It also happens when I turn from one side to the other in bed. And what I discovered is, if I block the carotid artery with my fingers for a little while, the pulse noise and pressure feeling gets worse at first, but they disappear and don't come back the moment I let go of my hand! Do you have any idea why that happens?
An account Sounds like a good time to establish care with a primary care provider and possibly get referred to a vascular surgeon
it is possible you have valvular heart disease, maybe aortic regurgitation, lying down would increase the amount of blood in your venous system, which will increase the amount of blood going to your heart, with regurgitation you are already adding more blood to the heart to pump out so when combined with the regurg it can manifest as significant increase in systolic pressures which can translate to significant pressures in the carotids, also look into underlying connective tissue disease
How long for, how often????
until you achieve the results you're looking for and as often as needed. thanks!
Thanks so much. I'm looking for a way to stimulate more blood flow and oxygen to my head and lungs so this may help!! Thanks !
It isn't just the possibility of passing out.
I do this to stop my SVT episodes, but it does have some possible downsides. If you have fat/cholesterol deposit in your carotid artery, you can dislodge a piece of it, resulting in a stroke, maybe death.
Have you tried doing the modified Valsava Maneuver instead? It has a reasonably high level of success in the field and our Ambulance service do it for our SVT patients. The risks associated with it are lower than with carotid massage but it can still result in clot dislodgement and severe bradycardia, just less commonly than with the technique you are already using.
Valsalva didn't do anything for me. Since my previous post, I had another catheter ablation for WPW syndrome -- same spot as 17 years ago (i.e., they didn't quite fix it back then, but the fix did last 15 years). SVT is gone again.
This is super cool...thanks your video was very helpful
Thank you so much!!
thank you for breaking it down for me!!! just subscribed!!!
I have no medical training, knowledge or intuition, should I attempt this?
Noic video, thank you!
great explanation
i am having these symptoms ... pressure , tightness in my neck,i have fainted , but before i do , everything in my neck feel like it is pinching off, even my hearing , i think i am having issues with this nerve....
+The57zzBride Possibly- see your primary care provider. Thanks-
How are you doing now?
Tim Ferris?
...sorry but first thought.
Thanks for the awsome video though.
friebender haha thanks- we wish we had Tim Ferris on our MSME team. Maybe someday
Med School Made Easy I massage my throat neck area before workouts and after as always think it will help blood flow to my brain,I also do this all over major arteries and organs in belieif that it will stir up the sedements in my system,might sound stupid to a doctor but I like believing my own ideas about health sometimes..
aaahhhh I finally understand everything, THANK YOU
This is not safe to do yourself, might result into some serious complications. Let your doctor, who will take all the necessary precautions, do it for you if you need it.
Is it safe to do if your not having any heart issues. Like if your following along with the video and just learning. Because my first instinct was to follow along while he was doing it.
Good job
It's massage help to reduce the SV Tschycardia
Thank you..i will try
My fitness freak brother, who's also a health freak, received a similar massage and he lost consciousness inside the massage room.
It triggered a Hemorrhagic Stroke.
Omg was he ok?!
...you mean ischemic stroke.
thanks, that was very helpful :)
No puls here, I guess I'm dead or something like that.
Hi am deepu am from india I suffering from AVM on right upper eye lid a doctor suggest me dat my AVM is cured through caratod compression massage . It is high risk on embolization. doctor said?
show some therapies that can be deadly i want to die but i dont want it to look like suicide
Why in AF?
Your brain will try to compensate for the drop in BP by increasing the heart rate, which could be a dangerous in some individuals.
I'm thinking he's a medic. There are a lot of risks. Carotid stenosis, risk of causing a stroke/TIA, etc. Please don't practice medicine, unless you're a doctor. I've worked with doctors that weren't comfortable doing it due to the patient's medical history.
helpful!!!
Good.
Thank u
The vagal manuver will stop the heart its the bodys reset button the way you describe it does not work
thanks for weighing in!
Make new videos please 😄😄
Keep going
help me die i have multiple sclerosis
Not evil but is this how Strangulation works
This is a way to incapacitate someone as wel
No don’t do it at home
❤️
this video is full of inaccuracies