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Successful treatment of deglutition syncope with oral beta-adrenergic blockade
T M Marshall1, H F Mizgala, J A Yeung-Lai-Wah
1Division of Cardiology, University of British Columbia, Vancouver.
Abstract:
A case of deglutition syncope of 20 years' duration in a patient without cardiac or esophageal disease is presented. The therapeutic efficacy of beta-blockade is documented by symptomatic improvement, repeat esophageal balloon inflation and tilt-table testing. This suggests the Bezold-Jarisch reflex or sympathetic nervous system may be involved in the pathogenesis of deglutition syncope.
Insights
Deglutition syncope, a swallowing-induced fainting, was effectively treated with beta-blockade in a patient with no heart or esophageal issues. This suggests the Bezold-Jarisch reflex or sympathetic nervous system may play a role.
Area of Science:
- Cardiology
- Gastroenterology
- Neurology
Background:
- Deglutition syncope is a rare condition characterized by syncope (fainting) triggered by swallowing.
- The underlying pathophysiology is not fully understood, with cardiac and esophageal causes often investigated.
Observation:
- A case study of a patient experiencing deglutition syncope for 20 years is presented.
- The patient had no identifiable cardiac or esophageal disease contributing to the condition.
Findings:
- Beta-blockade therapy demonstrated significant symptomatic improvement in the patient.
- Esophageal balloon inflation and tilt-table testing supported the efficacy of the treatment.
Implications:
- The findings suggest that the Bezold-Jarisch reflex or the sympathetic nervous system may be implicated in the pathogenesis of deglutition syncope.
- This case highlights a potential therapeutic target for managing deglutition syncope in select patients.