Which finding constitutes a contraindication to carotid massage?

• A. Regular Radial Pulse
• B. Clear Lungs
• C. Carotid Bruit
• D. Normal Blood Pressure

Answer: (C)

Carotid sinus massage relies on triggering the baroreflex to slow the heart, but it becomes dangerous if there’s carotid artery disease. A carotid bruit signals atherosclerotic plaque in the carotid artery, meaning the vessels are irregular and possibly unstable. Massaging the carotid can dislodge plaque or disrupt cerebral blood flow, increasing the risk of embolization and stroke. That’s why a carotid bruit is a contraindication.

Other findings don’t inherently raise the same risk. A regular radial pulse suggests the heart rate is stable and not currently causing hemodynamic issues that require manipulation. Clear lungs indicate no fluid overload or heart failure effects that would complicate a procedure. Normal blood pressure does not indicate a risk from massage; it simply reflects current hemodynamics being within a typical range.