Disease of The Carotid Sinus
The carotid sinus often has atherosclerotic plaques because of disturbed hemodynamics (low wall shear stress, flow reversal/recirculation). Since these plaques, if large and unstable, predispose to ischemic strokes and transient ischemic attacks, carotid endarterectomies are frequently done for prophylaxis.
The carotid sinus can be oversensitive to manual stimulation, a condition known as carotid sinus hypersensitivity, carotid sinus syndrome or carotid sinus syncope, in which manual stimulation causes large changes in heart rate and/or blood pressure. This classically presents as a patient who has "fainted" on several occasions while shaving, or in some other way coming into contact with their carotid sinus.
Carotid sinus syndrome is a temporary loss of consciousness that sometimes accompanies convulsive seizures because of the intensity of the carotid sinus reflex when pressure builds in one or both carotid sinuses.
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“Is not disease the rule of existence? There is not a lily pad floating on the river but has been riddled by insects. Almost every shrub and tree has its gall, oftentimes esteemed its chief ornament and hardly to be distinguished from the fruit. If misery loves company, misery has company enough. Now, at midsummer, find me a perfect leaf or fruit.”
—Henry David Thoreau (1817–1862)