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What Causes Swallow Syncope?
Question: First thing in the morning I always drink 2 glasses of water. I have been doing this for years and I have no problem. Last November 10 woke up 6am to get ready to work and of course I drank my first glass of water. I felt tummy pain lean to the basin and that is all I remember. All I know was my husband was frantically waking me up, I was confuse did not know what happen but I remember that I drank water. My husband rang the ambulance and I ended up in the Emergency Department in the hospital for 4 hours because I hit my head on the bath tub and pretty shaken. All my vital signs and blood test and ECG were normal. They say I had syncope attack and was discharged. 4 days after at 2 am I woke up went to the toilet and drunk a glass of water but made sure I was sitting down on the bed just in case. And my God everything just turn around and I started to vomit everything I eat mostly undigested food. My husband call the ambulance again but I did not go to the hospital because I was feeling better when they came. I went to the doctor today and same thing, I had syncope attack. I still feel lightheaded and a bit giddy when I drink water.
Brief Answer:
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
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
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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