Swallow syncope is a rare form of situational syncope associated with a vasovagal stimulus caused by mechanoreceptors in the esophagus. Vagal stimulation may trigger bradycardia or it may result in sympathetic withdrawal with peripheral vascular dilatation and hypotension.


Synonym: deglution syncope, esophageal syncope


Clinical features:

(1) dizziness, lightheadedness, faintness or loss of consciousness associated with swallowing and/or eating

(2) evidence of bradycardia, arteriovenous block and/or hypotension

(3) exclusion of other causes


Drinking a cold carbonated beverage is a common triggering event.


Factors that may initiate or potentiate the syndrome:

(1) myocardial infarction

(2) intrinsic heart disease

(3) following thoracic surgery

(4) drugs

(5) achalasia

(6) esophageal or bronchial cancer


A patient with bradycardia or AV block may benefit from a cardiac pacemaker.


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