Abstract
BackgroundSwallowing-induced syncope is rare and there are few case reports of it in the existing medical literature. Even rarer are instances involving young and healthy individuals, with no existing pre-conditions or apparent risk factors. Hence the value of such case reports in understanding the phenomenon better and potentially inferring patterns of practical interest is significant; here we describe an unusual case of a swallowing-induced syncope in a young, healthy, and active white man.Case presentationA healthy 32-year-old white man experienced a syncopal episode following the ingestion of a cold carbonated beverage on a hot day. He rapidly recovered consciousness and save for mild lightheadedness all ill effects disappeared within minutes. On examination no concerns were detected and he was discharged, with the cause being ascribed to esophageal stimulation effected vagus nerve overactivation.ConclusionsThe suddenness and unpredictability of swallowing-induced syncope make it a potentially dangerous condition, with risks both to the patient as well as, depending on the context, others. However, it is poorly understood due to its infrequency. The present case report adds to the body of much needed evidence which should help facilitate an improved understanding of the phenomenon.
Highlights
Vasovagal syncope induced by swallowing is rare. This makes it difficult to study and collect reliable evidence on causes, populations at risk, symptoms, recovery, and so on. Considering this practical challenge and the high potential of serious consequences that a sudden loss of consciousness can have, it is imperative to encourage diligent reporting of case studies as a means of systematically collecting information on the phenomenon so that it is better understood by practitioners and individuals at risk
The present article contributes the following: (i) it adds to the body of evidence through a description of a unusual case of swallowing-induced syncope, and (ii) it highlights the need for reports of this nature both for the specific condition at hand as well as in general for rare conditions which share the same practical challenge of data scarcity
At the time of examination, approximately 30 minutes following the syncope, his body mass was 102 kg and height 188 cm with a body mass index (BMI) of 28.9. He self-reported an active lifestyle and regular involvement in challenging resistance training (4–5 times a week), Arandjelović Journal of Medical Case Reports (2020) 14:37 corroborated by his high lean body mass (LBM) and low body fat (BF) (8%); there was no history of recreational or performance-enhancing drug use, and no use of medications. He had experienced no prior episodes of syncope, he did note experiencing sensations similar to those leading to the present episode upon swallowing cold carbonated beverages in the past; the frequency of these sensations was not deemed unusual or as warranting further investigation
Summary
The suddenness and unpredictability of swallowing-induced syncope make it a potentially dangerous condition, with risks both to the patient as well as, depending on the context, others. It is poorly understood due to its infrequency. The present case report adds to the body of much needed evidence which should help facilitate an improved understanding of the phenomenon
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