3. Presence of carotid bruit during the neck auscultation. The test consists of doing pressure and circular movements during 10 sec. on each carotid sinus, allowing an interval of 1 min. between both sides. The massage is made at 0 and 60 degrees tilt. It is considered a vasodilatory response if the systolic BP falls at least 50 mmHg, and chronotropic response if an asystole is induced for 3 or more sec. If this latter occurs, it is expected the patient to recover and the carotid massage is repeated after applying atropine 1 mg. If still positive for syncope it is considered a mixed response to the CSM.