
What Causes Swallow Syncope?

It is swallow syncope
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
1. It appears to be swallow syncope
2. The mechanism involves impulses from Gastro intestinal tract affecting the heart that can produce a variety of bradyarrythmias with atrioventricular block.
3. It occurs within 3-5 seconds of swallowing. Frequently triggered by liquids, particularly cold carbonated beverages. Bolus of food or any solid are also known to cause swallow syncope.
4. Change in drinking/eating habits is often helpful. Pacemakers (Rate responsive, dual chamber) may be needed. However a confirmation with telemetry monitoring or electrophysiological tests during induction of swallow syncope may demonstrate low heart rate.
5. Esophagus pathology also needs to be ruled as in few cases, a stricture or hernia is known to have caused it.
6. I am not sure about the investigations done. Barium swallow of esophagus and telemetry or monitoring of ECG during swallow induced episodes could demonstrate bradyarrythmias or decreased heart rate.
7. Anti-cholingergic medications to block vagal conduction or Beta blockers in few cases have known to be helpful.
Meet your doctor to get the investigations done. After a confirmation, based on pathology identified, appropriate treatment can be possible.
Get well soon.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM

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