Swallowing: Is It a Carotid Massage Equivalent Causing Syncope in Patients With Neck Masses?
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Syncope associated with the act of swallowing (deglutition syncope) and syncope associated with head and neck cancers have been documented independently. We present a case of syncope precipitated by a combination of both these mechanisms. It is important to recognize the coexistence of different hemodynamically significant mechanisms leading to syncope. A 66-year-old male recently diagnosed with head and neck cancer presented with syncope associated with eating. Diagnosis was complicated because of multiple factors in this patient, which individually could have led to syncope. The patient was on beta-blocker therapy, had a neck mass, and the episodes were associated with swallowing. Our hypothesis is that all these etiologies together led to the events but not in their typical mechanisms and raises the possibility that swallowing can be considered a carotid massage equivalent in patients with neck masses not physically extending to the carotid sinus.
- Linzer M, Yang EH, Estes NA, et al. Diagnosing syncope. Part 2. Unexplained syncope. Clinical efficacy assessment project of the American College of Physicians. Ann Intern Med. 1997;127:76–86.
- Farb A, Valenti SA. Swallow syncope. Md Med J. 1999;48(4):151–4.
- Johnson RH. Syncope without heart disease. In: Johnson RH, Lambie D, SplaldingJM (eds). Neurocardiology. Philadelphia: Saunders; 1984:159–84.
- Palmer ED. The abnormal upper gastrointestinal vagovagal reflexes that affect the heart. Am J Gastroenterol. 1976;66:513–22.
- Steven J, John RS. Swallow syncope associated with complete atrioventricular block: a case report and review of the literature. Milit Med J. 1989;154:465–6.
- Guberman A, Catching J. Swallow syncope. Can J Neurol Sci. 1986;13:267–9.
- Rothstein SG, Jacobs JB, Reede DL. Carotid sinus hypersensitivity secondary to parapharyngeal space carcinoma. Head Neck Surg. 1987;9:332–5. CrossRef
- Dykman TR, Montgomery EB Jr, Gerstenberger PD, et al. Glossopharyngeal neuralgia with syncope secondary to tumor: treatment and pathophysiology. Am J Med. 1981;71:165–70. CrossRef
- Cicogna R, Bonomi FG, Curnis A, et al. Parapharyngeal space lesions syncope-syndrome. A newly proposed reflexogenic cardiovascular syndrome. Eur Heart J. 1993;14(11):1476–83.
- Munro NC, McIntosh S, Lawson J, et al. Incidence of complications after carotid sinus massage in older patients with syncope. J Am Geriatr Soc. 1994;42:1248–51.
- Morley CA, Perrins EJ, Grant P, et al. Carotid sinus syncope treated by pacing. Analysisof persistent symptoms and role of atrioventricular sequential pacing. Br Heart J. 1982;47:411–18. CrossRef
- Hawkins J, Lewis HD, Emmot W, Vacek JL. Vasodepressive carotid sinus hypersensitivity with head and neck malignancy: treatment with propanolol. Am Heart J. l99l;122:234–5. CrossRef
- Strasberg B, Sagie A, Erdman S, et al. Carotid sinus hypersensitivity and the carotid sinus syndrome. Prog Cardiovasc Dis. 1989;31:379–91. CrossRef
- Choi YM, Mafee MF, Feldman LE. Successful treatment of syncope in head and neck cancer with induction chemotherapy. J Clin Oncol. 2006;24:5332–3. CrossRef
- Macdonald DR, Strong E, Nielsen S, et al. Syncope from head and neck cancer. J Neurooncol. 1983;1:257–67. CrossRef
- Bauer CA, Redleaf MI, Gartlan MG, et al. Carotid sinus syncope in head and neck cancer. Laryngoscope 1994:104;497–503.
- Swallowing: Is It a Carotid Massage Equivalent Causing Syncope in Patients With Neck Masses?
Journal of General Internal Medicine
Volume 22, Issue 12 , pp 1778-1780
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- head and neck cancer
- carotid massage
- Industry Sectors