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Swallow Syncope Associated With Intermittent Sinus Pause and High-Degree Atrioventricular Block: A Case Report
Kevin Malone1, Malak Modi2, Sandeep Koripalli3
1Emergency Medicine, Louisiana State University Health Sciences Center, Shreveport, USA.
Cureus
|April 11, 2022
Summary
Swallow syncope (deglutition syncope) is a rare neurogenic disorder triggered by eating. Early diagnosis and pacemaker implantation effectively treat this condition, resolving symptoms.
Area of Science:
- Cardiology
- Neurology
- Gastroenterology
Background:
- Swallow syncope, or deglutition syncope, is a rare neurogenic disorder.
- It is triggered by oral intake and can be challenging to diagnose.
- Early identification is crucial for effective treatment.
Observation:
- A 68-year-old female presented with lightheadedness and dizziness related to swallowing.
- High-degree atrioventricular block was observed on telemetry during meals.
- A temporal link between swallowing cold water and ECG changes (prolonged P-R interval) was established.
Findings:
- The patient was diagnosed with swallow syncope.
- Electrophysiology consultation led to pacemaker implantation.
- Symptoms of swallow-associated arrhythmias resolved post-pacemaker placement.
Implications:
- This case highlights the diagnostic challenges of swallow syncope.
- It underscores the treatability of swallow syncope once identified.
- Prompt diagnosis and intervention, such as pacemaker implantation, can significantly improve patient outcomes.
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