Swallow Syncope: a Case Report and Review of the Literature

Overview

Journal Clin Med Res

Specialty General Medicine

Date 2011 Jan 26

PMID 21263060

Citations 20

Authors

Subhashis Mitra

Tiffany Ludka

Shereif H Rezkalla

Param P Sharma

Jiangming Luo

Affiliations

Soon will be listed here.

Abstract

Swallow or deglutition syncope is a relatively rare syndrome. It is a vagally mediated syncope induced by swallowing. Swallow syncope may occur in all age groups and, when diagnosed, is treatable. A woman, aged 60 years, presented with an episode of a syncopal attack associated with swallowing a sandwich. She had a 6-month history of recurrent episodes of lightheadedness while eating solid foods. Telemetry monitoring demonstrated several episodes of severe bradycardia and complete atrioventricular block with up to a 7.0 second pause associated with meals. Computed tomography of the head and neck revealed no significant findings, and barium esophagram was normal. Echocardiogram was within normal limits. Her symptoms resolved after permanent pacemaker placement. Herein, we review the diagnosis, mechanism, and management of swallow syncope.

Citing Articles

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Post Total Thyroidectomy Deglutition Syncope.

Jailani M, Barbarawi M, Tigadi S Cureus. 2022; 14(12):e32836.

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Swallow Syncope Associated With Intermittent Sinus Pause and High-Degree Atrioventricular Block: A Case Report.

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Deglutition Syncope Due to Exaggerated Vagal Reflex.

Piao X, Chaney M, Ying G, Sharko A, Samuel S Cureus. 2021; 13(6):e16005.

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Management of an Unusual Case of Dysphagia.

Shah R, Mayuga K, Gabbard S Dysphagia. 2019; 35(2):399-400.

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References

Casella F, Diana A, Bulgheroni M, Solbiati M, Ceriani E, Pentimalli F . When water hurts. Pacing Clin Electrophysiol. 2009; 32(11):e25-7. DOI: 10.1111/j.1540-8159.2009.02521.x. View

Maekawa T, Suematsu M, Shimada T, Go M, Shimada T . Unusual swallow syncope caused by huge hiatal hernia. Intern Med. 2002; 41(3):199-201. DOI: 10.2169/internalmedicine.41.199. View

Turan I, Ersoz G, Bor S . Swallow-induced syncope in a patient with achalasia. Dysphagia. 2005; 20(3):238-40. DOI: 10.1007/s00455-005-0014-0. View

Oishi Y, Ishimoto T, Nagase N, Mori K, Fujimoto S, Hayashi S . Syncope upon swallowing caused by an esophageal hiatal hernia compressing the left atrium: a case report. Echocardiography. 2004; 21(1):61-4. DOI: 10.1111/j.0742-2822.2004.03005.x. View

Leitman M, Zyssman I, Abuhatzera S, Vasserman M, Ben Baruh C, Vered Z . A 37-year-old man with recurrent fainting: a short communication. Eur J Echocardiogr. 2010; 11(7):E30. DOI: 10.1093/ejechocard/jeq038. View

Patsilinakos S, Antonatos D, Spanodimos S, Nikolaou N, Sotirellos K, Korkonikitas P . Swallow syncope in a patient with esophageal stenosis caused by an ascending aorta aneurysm: differential diagnosis from postprandial hypotension: a case report. Angiology. 2007; 58(1):126-9. DOI: 10.1177/0003319706295514. View

Endean E, Cavatassi W, Hansler J, Sorial E . Deglutition syncope: a manifestation of vagal hyperactivity following carotid endarterectomy. J Vasc Surg. 2010; 52(3):720-2. DOI: 10.1016/j.jvs.2010.04.012. View

Lee G, Chang B, Song J, Ok C, Sohn S, Jo H . Deglutition syncope associated with ventricular asystole in a patient with permanent atrial fibrillation. Korean Circ J. 2010; 40(2):99-101. PMC: 2827811. DOI: 10.4070/kcj.2010.40.2.99. View

Armstrong P, McMillan D, Simon J . Swallow syncope. Can Med Assoc J. 1985; 132(11):1281-4. PMC: 1346334. View

10.

Karamitsos T, Arnold J, Rider O, Francis J, Ferrett C, Neubauer S . Massive hiatus hernia impeding transoesophageal echocardiography in a patient with swallow-syncope syndrome. Hellenic J Cardiol. 2009; 50(3):216-7. View

11.

Woodruff J, Prudente L . Update on implantable pacemakers. J Cardiovasc Nurs. 2005; 20(4):261-8. DOI: 10.1097/00005082-200507000-00012. View

12.

MARSHALL T, MIZGALA H, Steinbrecher U . Successful treatment of deglutition syncope with oral beta-adrenergic blockade. Can J Cardiol. 1993; 9(10):865-8. View

13.

Kang K, Cho W, Kim M, Chang H, Chung J, Won D . Cases of swallow syncope induced by the activation of mechanorecepters in the lower esophagus. Korean J Intern Med. 2005; 20(1):68-71. PMC: 3891415. DOI: 10.3904/kjim.2005.20.1.68. View

14.

Farb A, Valenti S . Swallow syncope. Md Med J. 1999; 48(4):151-4. View

15.

Fahrner A, Rennhofer A, Kalmann N, Roggla G . Swallow syncope. Eur J Emerg Med. 2008; 15(2):122-3. DOI: 10.1097/MEJ.0b013e3282f213ad. View

16.

Bajwa S, Stewart J, Treadwell S, Lakhani D . Swallow syncope: reflex or reflux?. Postgrad Med J. 2008; 84(989):160-2. DOI: 10.1136/pgmj.2007.062869. View

17.

Favaretto E, Schenal N, Russo N, Buja G, Iliceto S, Bilato C . An uncommon case of right-sided throat pain and swallow syncope. J Cardiovasc Med (Hagerstown). 2008; 9(11):1152-5. DOI: 10.2459/JCM.0b013e32830f42b1. View

18.

Boos C, Martin U, Cherry R, Marshall H . Dangerous sandwiches. Lancet. 2008; 372(9656):2164. DOI: 10.1016/S0140-6736(08)61932-7. View

19.

Gordon J, Saleem S, Ngaage D, Thorpe J . Swallow syncope associated with paroxysmal atrial fibrillation. Eur J Cardiothorac Surg. 2002; 21(3):587-90. DOI: 10.1016/s1010-7940(01)01172-1. View

20.

Gawrieh S, Carroll T, Hogan W, Soergel K, Shaker R . Swallow syncope in association with Schatzki ring and hypertensive esophageal peristalsis: report of three cases and review of the literature. Dysphagia. 2006; 20(4):273-7. DOI: 10.1007/s00455-005-0024-y. View