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[Auriculo-ventricular block upon swallowing].

M Bernasconi, G Brambilla, F Fiorista

Schweizerische Medizinische Wochenschrift

|December 21, 1985

Summary

This summary is machine-generated.

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A 70-year-old woman experienced recurrent fainting due to swallowing-induced heart block. A pacemaker resolved her symptoms, highlighting a rare connection between esophageal issues and cardiac events.

Area of Science:

Cardiology
Gastroenterology
Clinical Electrophysiology

Background:

Recurrent syncope can have various underlying causes, including cardiac and gastrointestinal conditions.
Oesophageal hiatus hernia is a common condition that can sometimes be associated with atypical symptoms.

Observation:

A case study involving a 70-year-old female patient presenting with recurrent syncopal episodes.
The patient had a diagnosed oesophageal hiatus hernia.
Dynamic electrocardiogram (ECG) monitoring revealed intermittent second and third-degree atrioventricular (A-V) block specifically during the act of swallowing solid food.

Findings:

Basal electrophysiologic examination showed normal cardiac conduction.
During solid food swallowing, electrophysiologic testing induced a second-degree A-V nodal block with a 2:1 conduction ratio.

Related Experiment Videos

The administration of atropine did not alter or prevent the swallowing-induced A-V block, suggesting a non-cholinergic mechanism.

Implications:

This case suggests a potential link between oesophageal hiatus hernia and "swallowing A-V block."
Permanent cardiac pacing (VVIP) effectively eliminated syncopal symptoms, indicating its therapeutic role in such cases.
Understanding the pathogenetic mechanism of swallowing-induced A-V block is crucial for diagnosing and managing similar rare conditions.