Background: Swallow or deglutition syncope is an unusual type of neurally-mediated syncope associated with life-threatening bradyarrhythmia and hypotension. It is a difficult condition to diagnose with commonly delayed diagnosis and management. There is lack of review articles that elucidate the basic demographics, clinical characteristics and management of this rare condition. This publication systematically reviews the 101 case reports published since 1793 on swallow syncope.
Case Presentation: A 59-year-old man presented with the complaint of recurrent dizziness associated with meals. A 24-h ambulatory ECG recording confirmed an episode of p-wave asystole at the time of food intake. Oesophagogastroduodenoscopy with balloon inflation in the mid to lower oesophagus resulted in a 5.6 s sinus pause. The patient's symptoms resolved completely following insertion of a permanent dual chamber pacemaker.
Conclusions: Swallow syncope is extremely rare, but still needs to be considered during diagnostic workup. It is commonly associated with gastro-intestinal disease. Permanent pacemaker implantation is the first line treatment.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686266 | PMC |
| http://dx.doi.org/10.1186/s12872-019-1174-4 | DOI Listing |
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Article Synopsis
- * Medical examinations revealed severe hypotension and issues with esophageal motility, including lower esophageal stricture and hypercontraction, while high-resolution manometry indicated premature contractions and reduced peristalsis.
- * The man's symptoms related to food stagnation and vomiting improved after endoscopic balloon dilation, highlighting that distal esophageal spasm (DES) can be a complication in MSA patients.
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