Swallow-induced syncope and carotid sinus hypersensitivity: Coincident or associated conditions?
Swallow induced syncope is a rare clinical condition which is thought to result from an abnormal vagal reflex leading to bradycardia and cerebral hypoperfusion. It mostly occurs in patients with organic or functional disorders of the esophagus, and often requires permanent pacemaker implantation, along with treatment of the underlying esophageal pathology. In the following case, we report of a 71-year-old male with achalasia post per oral endoscopic myectomy, who presented with syncope and documented AV-block while eating solid food. In addition, long sinus pauses were noted during carotid sinus massage, suggesting that the two distinct entities may be associated, and further supporting the mechanism of neurally mediated syncope in the pathophysiology of swallow-induced syncope.
Department of Cardiology, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Eed Abu
EA
Zaid
Department of Cardiology, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Moti
M
Haim
Department of Cardiology, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: h.alnsasra@gmail.com.
Hilmi
H
Alnsasra
Department of Cardiology, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Yuval
Y
Konstantino
D000368:Aged; D002346:Carotid Sinus / Q000503:physiopathology*; D004562:Electrocardiography; D004931:Esophageal Achalasia / Q000150:complications* / Q000503:physiopathology*; D004945:Esophagoscopy; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D013575:Syncope / Q000209:etiology* / Q000503:physiopathology* / Q000517:prevention & control
Achalasia; Complete atrio-ventricular block; Sinus pause