Swallow Syncope After Whiplash Neck Injury

Authors

  • Luka Lipar Department of Cardiology, University Medical Center, Ljubljana, Ljubljana, Slovenia
  • Pia Vovk Department of Anaesthesiology and Surgical Intensive Therapy, University Medical Center, Ljubljana, Ljubljana, Slovenia
  • Tereza Weiss Medical School, University of Ljubljana, Ljubljana, Slovenia
  • Jus Ksela Cardiovascular Surgery, University Medical Center, Ljubljana, Ljubljana, Slovenia

DOI:

https://doi.org/10.1532/hsf.1933

Keywords:

swallow syncope, deglutition syncope, reflex-mediated vasomotor inhibitory syndrome, dysautonomic syndrome, whiplash neck injury

Abstract

Swallow syncope is a rare dysautonomic syndrome characterized by temporary loss of consciousness upon swallowing solid foods or liquids, displaying primarily in individuals with an underlying structural or functional esophageal or cardiac pathology. However, the evidence also suggests that isolated vagal dysfunction or abnormal reactions of esophageal mechanoreceptors after mechanical irritation, demyelination, or trauma can potentially evoke  a cardioinhibitory response or vasodepression upon swallowing. We present a case of a 49-year-old otherwise healthy female patient who developed swallow syncope two weeks after whiplash neck injury acquired in a rear-end collision. After no evident anatomical and/or functional cardiac or esophageal pathology was diagnosed using several diagnostic procedures, the final diagnosis was confirmed by a provocative tilt-table test while ingesting solid food. Subsequently, a dual-chamber pacemaker was implanted, relieving the patient from troublesome symptoms. Abnormal reactions of esophageal mechanoreceptors to stimuli associated with food ingestion and/or dysfunction of afferent and efferent vagal fibers due to stretch injury and related neck trauma (acquired during the car accident) may be the leading pathophysiological mechanisms of swallow syncope in our patient.

Author Biography

Jus Ksela, Cardiovascular Surgery, University Medical Center, Ljubljana, Ljubljana, Slovenia

Department of Cardiovascular Surgery

Stuff surgeon

MD, PhD

Assistant Professor of surgery, Ljubljana Medical School

References

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Published

2018-03-05

How to Cite

Lipar, L., Vovk, P., Weiss, T., & Ksela, J. (2018). Swallow Syncope After Whiplash Neck Injury. The Heart Surgery Forum, 21(2), E084-E086. https://doi.org/10.1532/hsf.1933

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