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[A case of swallow syncope].

P Trinco¹, B Falque², A-C Stilman³

¹Service des Urgences, CHR Huy, Belgique.

Revue Medicale De Liege

|April 7, 2017

Summary

Swallow syncope, a rare cause of fainting during meals, can be effectively treated. Pacemaker implantation resolved recurrent episodes in an elderly patient experiencing severe bradycardia.

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Area of Science:

Cardiology
Neurology
Gastroenterology

Background:

Syncope represents a significant portion of emergency department visits.
Swallow syncope is an infrequent cardio-neurogenic condition with limited reported cases.
The pathophysiology involves a reflex arc triggered by deglutition, leading to cardiovascular events.

Observation:

An 83-year-old patient presented with recurrent syncope exclusively during meals.
Continuous telemetry monitoring identified severe bradycardia with an 8-second pause and complete atrioventricular block during syncopal episodes.
These findings strongly suggested swallow syncope as the underlying cause.

Findings:

The patient underwent successful implantation of a dual-chamber pacemaker.
Post-implantation, all syncopal episodes were completely abolished, confirming the efficacy of the intervention.
Diagnostic workup and therapeutic strategies for swallow syncope were reviewed.

Implications:

This case highlights the importance of considering swallow syncope in elderly patients with meal-related syncope.
Pacemaker implantation is a definitive treatment for severe bradycardia-induced swallow syncope.
Further research into the precise mechanisms and broader therapeutic options for this rare condition is warranted.

Keywords:

Dual chamber pacemaker Neurocardiogenic syncope Swallow syncope

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