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BMC Cardiovascular Disorders
Published in: BMC Cardiovascular Disorders 1/2019

Open Access 01-12-2019 | Atrioventricular Block | Case report

Swallow syncope: a case report and review of literature

Authors: Kelvin Shenq Woei Siew, Maw Pin Tan, Ida Normiha Hilmi, Alexander Loch

Published in: BMC Cardiovascular Disorders | Issue 1/2019

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Abstract

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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Metadata
Title
Swallow syncope: a case report and review of literature
Authors
Kelvin Shenq Woei Siew
Maw Pin Tan
Ida Normiha Hilmi
Alexander Loch
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2019
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-019-1174-4

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