Swallow syncope: reflex or reflux?

Area of Science:

• Cardiology
• Gastroenterology

Background:

• Syncope, or fainting, can be triggered by various physiological events.
• Food intake can precipitate specific cardiovascular responses in susceptible individuals.

Observation:

• A 51-year-old male patient reported a 5-year history of intermittent syncope exclusively associated with the consumption of solid foods.
• Cardiovascular investigations during food ingestion identified significant bradycardia (slow heart rate).

Findings:

• The patient's syncopal episodes were directly linked to bradycardia occurring during solid food consumption.
• Pacemaker insertion effectively eliminated the syncopal symptoms.

Implications:

• This case highlights the importance of considering cardiac causes, specifically reflex bradycardia, in patients presenting with food-induced syncope.
• Pacemaker therapy can be a successful intervention for managing this specific type of autonomic dysfunction related to eating.