Deglutition Syncope: Two Case Reports Attributed to Vagal Hyperactivity

Area of Science:

• Cardiology
• Neurology
• Neurally Mediated Reflex Syncopal Syndromes

Background:

• Deglutition syncope is a rare neurally mediated reflex syncope.
• It is triggered by the vagal reflex associated with swallowing.
• This reflex can cause atrioventricular block and a sudden drop in cardiac output.

Observation:

• This case series presents two patients experiencing deglutition syncope.
• The first patient was managed medically.
• The second patient underwent pacemaker implantation.

Findings:

• Deglutition syncope results from a vagal reflex during swallowing, leading to transient atrioventricular block.
• The cardiac output reduction causes symptoms of dizziness or syncope.
• Successful management can be achieved through medical intervention or device implantation.

Implications:

• Understanding the pathophysiology of deglutition syncope is crucial for accurate diagnosis.
• Treatment strategies should be individualized based on patient presentation and severity.
• Pacemaker implantation offers a viable option for refractory cases, improving patient outcomes.