Deglutition Syncope Due to Exaggerated Vagal Reflex.

Area of Science:

• Cardiology
• Neurology
• Gastroenterology

Background:

• Swallow syncope (deglutition syncope) is a rare condition characterized by syncope during food swallowing.
• It is associated with transient bradyarrhythmia and hypotension.
• Early diagnosis is crucial but often challenging due to its uncommon nature.

Observation:

• A 60-year-old female presented with intermittent lightheadedness after swallowing food.
• During a clinical visit, presyncope and a notable decrease in pulse rate were observed when she consumed a candy bar.
• Diagnostic workup, including ECG, carotid ultrasound, echocardiogram, and videofluoroscopic swallow study, yielded normal results.

Findings:

• The case illustrates a typical presentation of deglutition syncope.
• Diagnostic investigations did not reveal an alternative cause for the patient's symptoms.
• The observed physiological response during swallowing confirmed the diagnosis.

Implications:

• Raising awareness of swallow syncope in medical literature is essential for prompt recognition.
• Understanding its clinical manifestations can aid in preventing potentially life-threatening events.
• This case underscores the importance of considering reflex syncope syndromes in patients with unexplained presyncope or syncope related to swallowing.