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Myocardial Ischemia Presenting with Hiccups
1Department of Cardiothoracic Surgery, Division of Cardiac Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, Fujian Province, China.
Insights
Cardiac ischemia, including myocardial infarction, can cause hiccups. This review highlights electrocardiography for diagnosis and treatments like gabapentin, alongside interventions such as coronary artery bypass grafting for effective hiccup management.
Area of Science:
- Cardiology
- Neurology
Background:
- Myocardial infarction and ischemia are significant risk factors for cardiovascular hiccups.
- Hiccups originating from cardiac ischemia require specific diagnostic and therapeutic considerations, particularly in elderly patients.
Approach:
- A systematic review following PRISMA guidelines was conducted.
- Literature was analyzed to identify clinical features and treatments for cardiac ischemia-related hiccups.
Key Points:
- Electrocardiography is crucial for diagnosing cardiogenic etiology in elderly patients with unexplained hiccups.
- Gabapentin serves as a second-line treatment for hiccups, particularly useful when chlorpromazine is contraindicated.
- Inferior myocardial infarction is a common cause of cardiac hiccups.
Conclusions:
- Both symptomatic and etiologic treatments can resolve cardiac ischemia-related hiccups.
- Interventions range from anti-myocardial ischemia agents and percutaneous coronary intervention to coronary artery bypass grafting.
Abstract:
Myocardial infarction/ischemia can be an underlying etiology and a major causative risk factor of cardiovascular hiccups. The objective of this systematic review was to review the literature regarding clinical features and treatments of hiccups of cardiac ischemia origin. PRISMA guidelines were followed. In elderly patients with hiccups of uncertain causes, electrocardiography is necessary to ensure the cardiogenic etiology. Both symptomatic and etiologic treatments can be effective in terminating hiccups. Of the therapeutic regimens, gabapentin is a second-line agent alternative to baclofen in treating hiccups. It is especially helpful in patients undergoing stroke rehabilitation or palliative care when chlorpromazine is prohibited due to its adverse effects. Inferior myocardial infarction is the most common cause of hiccups in this patient setting. In addition to anti-myocardial ischemia agents and percutaneous coronary intervention, coronary artery bypass grafting could be an alternative to hiccups in such patients.
