ABSTRACT
Swallow syncope, also called deglutition syncope, is a rare disorder triggered by oral intake. Patients often have underlying esophageal or structural heart disease. In some cases, the condition can be treated conservatively by eliminating predisposing factors. We describe the case of a 65-year-old woman without cardiovascular or esophageal disease who presented after a motor vehicle accident that was attributed to syncope while driving and eating. In the hospital, the patient suddenly lost consciousness while eating solid food; complete heart block without ventricular escape was documented on continuous electrocardiographic monitoring. A dual-chamber permanent pacemaker was placed and completely resolved the symptoms. This case illustrates a high-risk manifestation of swallow syncope: asystole resulting from an exaggerated vago-glossopharyngeal reflex.
Subject(s)
Deglutition , Electrocardiography , Syncope/etiology , Aged , Cardiac Pacing, Artificial , Diagnosis, Differential , Endoscopy, Gastrointestinal , Female , Follow-Up Studies , Heart Rate , Humans , Reflex, Abnormal , Syncope/diagnosis , Syncope/physiopathology , Telemetry/methodsABSTRACT
Yawning occurs frequently in daily life and is often attributed to boredom and fatigue. Rarely, it may be a symptom of serious underlying medical illness, primarily involving the central nervous system. We report a case of acute cardiac tamponade resulting from a large, malignant pericardial effusion. The patient manifested striking repetitive yawning that resolved immediately after pericardial drainage. An association between repetitive yawning and acute cardiac tamponade has not been previously described.
