Swallow Syncope in a Patient With Esophageal Stenosis Caused by an Ascending Aorta Aneurysm: Differential Diagnosis From Postprandial Hypotension

Abstract

Swallow syncope is usually caused by organic or functional disorders of the esophagus due to abnormal vasovagal reflex. In elderly patients this situation could be confused with postpran-dial hypotension. We present a case of an elderly patient who presented with swallow syncope that was caused by a waist in the midportion of esophagus induced by an ascending aorta aneurysm.

Get full access to this article

View all access options for this article.

References

Johnson RH : Syncope without heart disease. In: Neurocardiology, ed. by Johnson RH , Lambie D , Spalding JM. Philadelphia: WB Saunders, 1984, pp 159-184.

Jansen RW , Connelly CM , Kelley-Gagnon MM , et al : Postprandial hypotension in elderly patients with unexplained syncope. Arch Inter Med 155: 945-952, 1995.

Drake C , Rollings H , Ham O , et al : Visually provoked complete atrioventricular block: An unusual form of deglutition syncope. Am J Cardiol 53: 1408-1409, 1984.

Nakagawa S , Hisanaga S , Kondoh H , et al : A case of swallow syncope induced by vagotonic visceral reflex resulting in atrioventricular node suppression. J Electrocardiol 20: 65-69, 1987.

Guberman A , Catching J : Swallow syncope. Can J Neurol Sci 13: 267-269, 1986.

Bortolotti M , Sarti P , Brunelli F , et al : Abnormal esophagocardiac inhibitory reflex in patients with diffuse esophageal spasm. Digestion 56: 488-492, 1995.

Grubb BP , Kosinski D : Current trends in the etiology, diagnosis and management of neurocardiogenic syncope. Curr Opin Cardiol 11: 32-41, 1996.

Abboud FM : Neurocardiogenic syncope. N Engl J Med 15: 1117-1117, 1993.

Kapoor WN : Syncope in the older person. J Am Geriatr Soc 42: 426-426, 1994.

10.

Thoren P : Role of cardiac vagal C-fibers in cardiovascular control. Rev Physiol Biochem Pharmacol 86: 1-1, 1989.

11.

Mark AL : The Bezold-Jarisch reflex revisited: Clinical implications of inhibitory reflexes originating in the heart. J Am Coll Cardiol 1: 90-90, 1983.

12.

Brignole M , Menozzi C , Gianfranchi L , et al : A controlled trial of acute and long-term medical therapy in tilt-induced neurally mediated syncope. J Am Coll Cardiol. 70: 339-339, 1992.

13.

Sra JS , Jazayeri MR , Avitall B , et al : Comparison of cardiac pacing with drug therapy in the treatment of neurocardiogenic (vasovagal) syncope with brady-cardia or asystole. N Engl J Med 328: 1085-1085, 1993.

14.

Basker MR , Cooper DK : Oesophageal syncope. Ann R Coll Surg Engl 82: 249-253, 2000.

15.

Farb A , Valenti SA : Swallow syncope. Md Med J 48: 151-154, 1999.