Saudi Journal of Gastroenterology
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Year : 2014  |  Volume : 20  |  Issue : 4  |  Page : 207-211

Swallow syncope: Clinical presentation, diagnostic criteria, and therapeutic options


1 Department of Medicine, The Johns Hopkins University/Sinai Hospital Program in Internal Medicine, Baltimore, MD, USA
2 Department of Medicine, The Johns Hopkins University/Sinai Hospital Program in Internal Medicine, Baltimore, MD; Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
3 Division of Gastroenterology, Sinai Hospital, Baltimore, MD, USA
4 Division of Gastroenterology, Sinai Hospital; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

Correspondence Address:
Dr. Mohit Girotra
Division of Gastroenterology, Department of Medicine, The Johns Hopkins University/Sinai Hospital Program in Internal Medicine, 2401 W. Belvedere Avenue, Suite 302, Baltimore, MD 21215
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-3767.136932

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We recently encountered three patients with episodes of syncope associated with food ingestion. A 31-year-old woman had an episode of syncope in the hospital while drinking soda. Transient asystole was noted on the telemonitor, confirming the diagnosis of swallow syncope. The other two patients were 78- and 80 year old gentlemen, respectively, who presented with recurrent and transient episodes of dizziness during deglutition. Extensive work-up of syncope was negative in both cases and a diagnosis of swallow syncope was made by clinical criteria. These cases illustrate the challenging problem of swallow syncope. The diagnosis can be suspected on the basis of clinical presentation and confirmed with the demonstration of transient brady-arrhythmia during deglutition. Medical management includes avoiding trigger foods, use of anticholinergics, and/or placement of a permanent cardiac pacemaker.


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