[Swallowing syncope in a patient with diffuse esophageal spasm]

Area of Science:

• Gastroenterology
• Cardiology
• Neurology

Background:

• Syncope, or fainting, can have various underlying causes.
• Esophageal motility disorders are increasingly recognized as potential triggers for autonomic dysfunction.

Observation:

• A patient presented with recurrent episodes of syncope specifically associated with swallowing.
• Esophageal manometry revealed diffuse esophageal spasms as the primary finding.

Findings:

• The diffuse esophageal spasms were identified as the cause of a vagovagal reflex.
• This reflex, mediated by esophageal wall tension receptors, led to atrioventricular (AV) and/or sinus node blockade.

Implications:

• This case highlights the importance of considering esophageal motility disorders in the differential diagnosis of unexplained syncope.
• Understanding the vagovagal reflex pathway provides insights into managing patients with swallowing-induced syncope.