Swallow Syncope: Clinical Presentation, Diagnostic Criteria and Therapeutic Options

First Reported Case of Deglutition Syncope With Underlying Suppurative Parotitis

“…6 As most DS causes are related to either gastroesophageal or cardiac causes, after doing 24 hours of telemonitoring and echocardiography for evaluating structural heart disorders, complete gastroesophageal evaluation with, but not limited to, barium swallow and esophagogastroduodenoscopy should be performed. 2,3…”

“…Sympathetic outflow can also be blunted, leading to overt parasympathetic outflow. [2][3][4] Moreover, mechanoreceptors in the lower esophageal region might also contribute to DS' pathogenesis, which can be reproduced by a fizzy drink challenge, causing abrupt pressure changes, leading to distension in the esophagus and balloon inflation test during esophagogastroduodenoscopy. 2,5 Because various reasons can compound to DS, its treatment can range from conservative management, avoidance of triggers such as medication including beta-blockers and calcium channel blockers, diet modification, and treatment of underlying cause to evaluation for and placement of permanent pacemakers.…”

“…6 As most DS causes are related to either gastroesophageal or cardiac causes, after doing 24 hours of telemonitoring and echocardiography for evaluating structural heart disorders, complete gastroesophageal evaluation with, but not limited to, barium swallow and esophagogastroduodenoscopy should be performed. 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.…”

“…DS is supposed to arise from an imbalance between the overfiring parasympathetic tract and underfiring sympathetic outflow tract, which leads to bradycardia, asystole, heart blocks, or hypotension. [1][2][3] DS has also been shown to overlap with carotid sinus hypersensitivity. 4 Most reported cases of DS had underlying cardiovascular and gastrointestinal causes.…”

Deglutition Syncope in a Healthy 9-Year-Old Boy: First of Its Kind in Africa. A Case Report and Literature Review.

“…Because of the challenge associated with its diagnosis, patients tend to present to clinicians across multiple disciplines (6,8). Usually, patients present with symptoms such as dizziness, chest tightness, lightheadedness, or an unconcealed syncope (9). This condition has been associated with various esophageal disorders such as esophageal spasm, stricture, achalasia, hiatal hernia, and esophageal cancer (7,9).…”