["Coffee swallowing syncope"].
METHODS
A 38-year-old man was admitted with recurrent syncope. Remarkably the patient had lost consciousness after drinking hot coffee. A vasovagal syncope was considered as the most likely diagnosis.


METHODS
Following various investigations no pathological findings were revealed. Event-monitoring (R-test) showed high grade atrioventricular block (2 Mobitz and 3 ) induced by swallowing with subsequent syncope.


METHODS
A two-chamber pacemaker was implanted and the antihypertensive therapy was changed from a beta-blocker to an AT II receptor antagonist.


CONCLUSIONS
Typical vasovagal symptoms during or shortly after meals followed by syncope should point towards an oesophago-cardia reflex mechanism; including a cardiac arrhythmia. Known to be usually triggered by cold meals, vasovagal reflex after hot meals is rare.
Sendi
P
P
Medizinische Universitätsklinik, Kantonsspital Liestal, Schweiz. sendi-pa@magnet.ch
Schmidt
Ch
Ch
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects; D000328:Adult; D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000145:classification / Q000627:therapeutic use; D001262:Atenolol / Q000009:adverse effects; D003069:Coffee / Q000009:adverse effects*; D003679:Deglutition; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006327:Heart Block / Q000175:diagnosis / Q000628:therapy; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D012008:Recurrence; D013575:Syncope / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D019462:Syncope, Vasovagal / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy
D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents; D003069:Coffee; D001262:Atenolol