Case Report

Clinical Autonomic Research

, Volume 9, Issue 6, pp 317-324

Baroreflex failure following radiation therapy for nasopharyngeal carcinoma

  • Henri J. L. M. TimmersAffiliated withDepartment of General Internal Medicine (541), St. Radboud University Hospital Nijmegen
  • , John M. KaremakerAffiliated withDepartment of Physiology, Academic Medical Center
  • , Jaques W. M. LendersAffiliated withDepartment of General Internal Medicine (541), St. Radboud University Hospital Nijmegen
  • , Wouter WielingAffiliated withDepartment of Internal Medicine, Academic Medical Center

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Abstract

The authors present a 51-year-old man with right-sided nasopharyngeal carcinoma who was treated for regional lymph node involvement by bilateral radiation therapy of the neck. Six years later he presented with episodic complaints of headache, flushing, and palpitations accompanied by elevations of blood pressure. Examination of arterial baroreflex function indicated selective afferent carotid sinus denervation. Cross spectral analysis of spontaneous heart rate and blood pressure variability showed decreased arterial baroreflex sensitivity (6.5 ms/mm Hg). Twenty-four hour measurements of blood pressure and heart rate variability showed labile hypertension during normal daytime activities. Baroreflex failure in this patient probably represents a late complication of bilateral radiation therapy of the neck.

Key words

baroreflex failure carotid sinus denervation radiation therapy ambulatory blood pressure measurement