Department of Medicine/Cardiology, University Malaya Medical Centre, Kuala Lumpur, Malaysia.
Department of Medicine/Geriatric, University Malaya Medical Centre, Kuala Lumpur, Malaysia.
BMC Cardiovasc Disord. 2019 Aug 7;19(1):191. doi: 10.1186/s12872-019-1174-4.
Swallow or deglutition syncope is an unusual type of neurally-mediated syncope associated with life-threatening bradyarrhythmia and hypotension. It is a difficult condition to diagnose with commonly delayed diagnosis and management. There is lack of review articles that elucidate the basic demographics, clinical characteristics and management of this rare condition. This publication systematically reviews the 101 case reports published since 1793 on swallow syncope.
A 59-year-old man presented with the complaint of recurrent dizziness associated with meals. A 24-h ambulatory ECG recording confirmed an episode of p-wave asystole at the time of food intake. Oesophagogastroduodenoscopy with balloon inflation in the mid to lower oesophagus resulted in a 5.6 s sinus pause. The patient's symptoms resolved completely following insertion of a permanent dual chamber pacemaker.
Swallow syncope is extremely rare, but still needs to be considered during diagnostic workup. It is commonly associated with gastro-intestinal disease. Permanent pacemaker implantation is the first line treatment.
吞咽性晕厥是一种不常见的神经介导性晕厥，与危及生命的心动过缓和低血压有关。由于通常诊断和管理延迟，这种情况很难诊断。缺乏阐明这种罕见病症的基本人口统计学、临床特征和管理的综述文章。本出版物系统地回顾了自 1793 年以来发表的 101 例吞咽性晕厥病例报告。
一名 59 岁男性因反复与进食相关的头晕就诊。24 小时动态心电图记录证实，在进食时出现 p 波停搏。食管胃十二指肠镜检查并用球囊在食管中下段充气导致窦性停搏 5.6 秒。在插入永久性双腔起搏器后，患者的症状完全缓解。
吞咽性晕厥极为罕见，但在诊断过程中仍需考虑。它通常与胃肠道疾病有关。永久起搏器植入是一线治疗方法。
