Swallow-induced syncope and carotid sinus hypersensitivity: Coincident or associated conditions?

Zaid, Eed Abu; Haim, Moti; Alnsasra, Hilmi; Konstantino, Yuval

doi:10.1016/j.jelectrocard.2017.03.011

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…Whether these observations are physiologically related or merely a coincidence is unclear. In this regard, Zaid et al noted a similar association. However, in their case, the patient was a 71‐year‐old male; in that circumstance, a coincidence is quite likely as CSH is common in older males.…”

Section: Discussionmentioning

confidence: 76%

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Swallow (deglutition) syncope: An evaluation of swallowing‐induced heart rate and hemodynamic changes in affected patients and control subjects

Kohno

Adkisson

Detloff

et al. 2018

Cardiovasc electrophysiol

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Background: Syncope triggered by swallowing is a well-known but uncommon condition that has been the focus of case reports but is otherwise largely unstudied. To better understand swallow syncope we examined heart rate (HR) and blood pressure (BP) changes during swallowing in clinically suspected swallow syncope patients and asymptomatic control subjects. Methods: The study population comprised four individuals with a history suggesting swallow syncope (three men, 53 ± 14.9 years) and 15 (nine men, 46 ± 17.1 years, P = NS vs patients) asymptomatic volunteer control subjects. Studies in all individuals comprised noninvasive beat-to-beat HR and BP measurement during swallowing 150 mL of cold liquid while standing. Additional tests in swallow syncope patients included: active standing, Valsalva maneuver, carotid sinus massage (CSM), and headup tilt (HUT).Results: Swallowing resulted in a greater decrease of both HR (−22 ± 22.1 vs −3 ± 11.7 beats/minute [bpm]; P = 0.045) and BP (−22 ± 17.4 vs − 2 ± 11.8; P = 0.036) in swallow syncope patients than in controls. Further, in swallow syncope patients the time to lowest HR and BP differed (9 ± 5.5 vs 19 ± 7.2 seconds; P = 0.02), suggesting that both cardioinhibitory (CI) and vasodepressor (VD) mechanisms are present but operate independently. Other autonomic studies were normal in swallow syncope patients except for CSM pause more than 3 seconds in two patients.Conclusion: Swallow syncope is associated with transient and temporally independent CI and VD features, consistent with reflex syncope. Potentially, a swallowing test during autonomic evaluation may be useful to unmask relative magnitudes of CI and VD responses, thereby facilitating treatment strategy decisions. K E Y W O R D S autonomics, head-up tilt, swallowing, syncope J Cardiovasc Electrophysiol. 2019;30:221-229. wileyonlinelibrary.com/journal/jce How to cite this article: Kohno R, Adkisson WO, Detloff BLS, Sakaguchi S, Benditt DG. Swallow (deglutition) syncope: An evaluation of swallowing-induced heart rate and hemodynamic changes in affected patients and control subjects.

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Section: Discussionmentioning

confidence: 76%

“…In past reports, the average age of swallowing syncope patients was 57 years (range, 15‐85 years), and 67% of patients were male . In some patients, severe sinus bradycardia and sinus arrest were documented, while in other reports, transient atrioventricular block was described …”

Section: Discussionmentioning

confidence: 99%

Swallow (deglutition) syncope: An evaluation of swallowing‐induced heart rate and hemodynamic changes in affected patients and control subjects

Kohno

Adkisson

Detloff

et al. 2018

Cardiovasc electrophysiol

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“…2,3 Carotid sinus hypersensitivity (CSH) has also been described in certain cases of syncopal events, and it is unclear whether they have an association with DS. 7 The carotid sinus is a dilated neurovascular structure at the junction of the internal and external carotid artery, which is enriched with baroreceptors; increased pressure in these sinuses can be sensed by afferent glossopharyngeal nerve fibers which transmit signals to nucleus solitarius and outflow of parasympathetic fibers, thereby cause bradycardia and/or hypotension. 8 Like DS, CSH is also common in the elderly population.…”

Section: Discussionmentioning

confidence: 99%

First Reported Case of Deglutition Syncope With Underlying Suppurative Parotitis

et al. 2021

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Deglutition syncope and carotid sinus hypersensitivity are neurally mediated events, leading to potentially dangerous arrhythmias and cardiovascular events. Mostly related to underlying gastroesophageal or cardiovascular causes, sometimes, this might not be the case. We report the first-ever documented case of deglutition syncope with acute suppurative parotitis, which resolved after resolving the parotid gland's swelling.

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Swallow (Deglutition) Syncope and Carotid Sinus Hypersensitivity

Kohno

Adkisson

Sakaguchi

et al. 2020

Cardiac Electrophysiology

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Swallow-induced syncope and carotid sinus hypersensitivity: Coincident or associated conditions?

Cited by 4 publications

References 5 publications

Swallow (deglutition) syncope: An evaluation of swallowing‐induced heart rate and hemodynamic changes in affected patients and control subjects

Swallow (deglutition) syncope: An evaluation of swallowing‐induced heart rate and hemodynamic changes in affected patients and control subjects

First Reported Case of Deglutition Syncope With Underlying Suppurative Parotitis

Swallow (Deglutition) Syncope and Carotid Sinus Hypersensitivity

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