Deglutition Syncope: A Case Report and Review of the Literature.
Deglutition syncope (DS) is a rare, neurally-mediated syncopal syndrome arising from an aberrant vagotonic reflex during swallow-associated esophageal dilation. Its association with gastroesophageal disorders often prompts gastroenterology consultation. An 89-year-old man with recent dysphagia and otalgia was admitted after a syncopal episode occurred while eating. Esophageal imaging and endoscopy demonstrated no causative abnormalities. Maxillofacial imaging revealed chronic sinusitis and mastoiditis. Telemetry monitoring demonstrated high-grade atrioventricular block and pause associated with swallowing. His symptoms and swallow-associated arrhythmia resolved after dual chamber pacemaker implantation. DS is highly treatable once identified and multidisciplinary coordination is helpful in optimizing outcomes and avoiding superfluous testing.
Department of Medicine, Mayo Clinic, Phoenix, AZ.
Allon
A
Kahn
Division of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, AZ.
Laura M
LM
Koepke
Division of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, AZ.
Sarah B
SB
Umar