title: Swallow syncope in association with Schatzki ring and hypertensive esophageal peristalsis: report of three cases and review of the literature.
abstract: Syncope caused by swallowing-induced cardiac arrhythmia is an uncommon condition. The recognition of this syndrome is paramount but often difficult. We report three cases of deglutition syncope evaluated at our institution over a three-year period. Two patients had distal esophageal (Schatzki) ring and two had hypertensive peristaltic waves (commonly referred to as "nutcracker esophagus"), neither of which had been described before in association with deglutition syncope. Two patients underwent placement of a demand cardiac pacemaker with subsequent resolution of their syncopal symptoms, while the third patient refused any further intervention. Swallow syncope usually follows a benign course from a cardiac standpoint. Placement of a demand cardiac pacemaker can prevent recurrence of presyncopal and syncopal attacks and their untoward consequences.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
authors.forename: Samer
authors.initials: S
authors.lastname: Gawrieh
authors.forename: Ty
authors.initials: T
authors.lastname: Carroll
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Hogan
authors.forename: Konrad H
authors.initials: KH
authors.lastname: Soergel
authors.forename: Reza
authors.initials: R
authors.lastname: Shaker
mesh_terms: D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000628:therapy*; D003680:Deglutition Disorders / Q000175:diagnosis*; D004562:Electrocardiography; D015154:Esophageal Motility Disorders / Q000175:diagnosis; D049631:Esophageal Sphincter, Upper / Q000002:abnormalities*; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012720:Severity of Illness Index; D013575:Syncope / Q000175:diagnosis*; D013577:Syndrome; D016896:Treatment Outcome