Question: Had transhiatal esophagectomy with partial gastrectomy and with pylorectomy for stage 3 esophageal adenocarcoma on 04/15/15. Recovered quickly and was discharged in one week. Had several episodes of late dumping syndrome with tachycardia, nausea, abdominal pain, and diaphoresis over next couple of months but finally learned how to avoid them. Now, for past two weeks, have been having daily episodes lasting 2 to 3 hours that include blacking out, vision changes, bradycardia (50s), hypotenson (sys bp 60s - 80s), diaphoresis, nausea, raspy voice, severe left-side headache. I've been to the E.R. and was diagnosed with vasovagal syndrome initiated by dehydration. My PCP believes it is vasovagal syndrome caused by hypoglycemia versus carotid sinus syndrome associated with a benign mass on my left submandibular gland. This gland is scheduled to be removed later this month. Head CTs have been normal. I am scheduled to see a cardiologist in 2 weeks - couldn't get an appt sooner. What do you think may be causing these episodes? My wife thinks I should be admitted in the hospital like yesterday. These episodes frighten her. When I start "looking funny" to her, she makes me lay down wherever I am and she elevates my legs. I lose conciousness if I don't lay down quickly enough and she tries to catch me - which has hurt her back. Thanks for your help. XXXXXX

Do you think the symptomatic bradycardia may be caused by possible damage during the esophagectomy to the vagus nerve? Do you think it may be caused by the sublinguinal salivary mass? Thank you.