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WMJ : Official Publication of the State Medical Society of Wisconsin
|September 13, 2014
Summary
Recurrent syncope in a 70-year-old man was linked to drinking carbonated beverages, causing ventricular pauses. A pacemaker resolved symptoms, highlighting the importance of detailed patient history in diagnosing syncope causes.
Area of Science:
- Cardiology
- Gastroenterology
Background:
- Syncope, or fainting, can have various underlying causes.
- Deglutition syncope is a rare condition where swallowing triggers a vasovagal response leading to syncope.
Observation:
- A 70-year-old male experienced recurrent syncope episodes coinciding with carbonated beverage consumption.
- Ambulatory cardiac monitoring detected multiple symptomatic ventricular pauses during these episodes.
- A barium esophagram was normal, ruling out esophageal structural abnormalities.
Findings:
- The patient received a dual-chamber pacemaker for deglutition syncope, which successfully resolved his symptoms.
- A subsequent challenge with carbonated beverages induced bradycardia, demonstrating the direct link between consumption and cardiac events.
- The pacemaker appropriately responded to the induced bradycardia, preventing syncope.
Implications:
- This case underscores the significance of a comprehensive patient history in identifying unusual syncope triggers.
- Carbonated beverages can precipitate cardiac events like bradycardia and syncope in susceptible individuals.
- Pacemaker implantation can be an effective treatment for specific types of deglutition syncope.