, Volume 33, Issue 6, pp 866–868 | Cite as

Dysphagia, Hyperglycemia, and Presyncope

  • Kishan J. PadaliaEmail author
  • Arjun J. Padalia
  • Milind G. Parikh
Clinical Conundrum


There have been over 80 documented cases of swallow syncope—a rare form of reflex or neurally mediated syncope—with most cases associated with an underlying esophageal disorder. Here, we describe the first reported case of swallow syncope or presyncope caused by an infectious esophagitis. Our 65-year-old patient initially developed dysphagia, odynophagia, and presyncope with swallowing. This lead to nutrition and medication avoidance behavior, which was followed by the development of diabetic ketoacidosis. The diagnosis of swallow presyncope was confirmed with a provocative swallow study demonstrating 8 s sinus arrest, and an underlying cause of Candida esophagitis was found by upper endoscopy. Symptoms completely resolved after treatment with micafungin.


Deglutition Swallow Deglutition disorders Dysphagia Syncope Candida Esophagitis Diabetic ketoacidosis 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of Central Florida College of MedicineOrlandoUSA
  2. 2.Central Florida Cardiology GroupFlorida HospitalOrlandoUSA

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