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Deglutition Syncope: Two Case Reports Attributed to Vagal Hyperactivity.

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Deglutition syncope, a rare reflex syncope, involves vagal nerve stimulation during swallowing, causing heart block and fainting. Management varies, including medical treatment and pacemaker implantation.

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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.