Abstract 13744: Carotid Sinus Syndrome With Symptomatic Bradycardia Due to Papillary Thyroid Cancer

Abstract

The patient is a 45-year-old male with no significant past medical history who presents to the hospital for an elective surgical neck mass biopsy. The patient started noticing a slow-growing neck mass six years ago, although he did not seek medical attention. While he was monitored in preoperative room, he developed symptomatic bradycardia. Telemetry showed a complete heart block rhythm. Upon further questioning, he had been having increasing episodes of near syncope for the past two months. Physical examination was significant for bradycardia without an audible murmur. A neck exam revealed a fixed right neck mass palpable across the midline to the left with a prominent thyroid isthmus. Carotid pulses were palpable bilaterally with no bruits. A temporary transvenous pacemaker was placed and the patient was admitted to the hospital for observation. Upon further workups, CT images 1 and 2 in supplemental section. A cervical lymph node biopsy eventually revealed metastatic papillary thyroid carcinoma. The patient was diagnosed with carotid sinus syndrome secondary to papillary thyroid cancer with a vasovagal component. He was discharged with a plan for radiation and close follow-up with an electrophysiologist to evaluate permanent pacemaker eligibility after receiving treatment for thyroid cancer.