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Case Reports
. 2007 Dec;22(12):1778-80.
doi: 10.1007/s11606-007-0402-2. Epub 2007 Oct 11.

Swallowing: is it a carotid massage equivalent causing syncope in patients with neck masses?

Manogna Maddineni  1 , Mukta Panda
Affiliations
Case Reports

Swallowing: is it a carotid massage equivalent causing syncope in patients with neck masses?

Manogna Maddineni et al. J Gen Intern Med. 2007 Dec.

Abstract

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.

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Figures

Figure 1
Figure 1
Computerized tomography and angiography of the head and neck. A multiloculated cystic structure within the left carotid space located anterior to the sternocleidomastoid muscle compressing the anterolateral margin of the left jugular vein.
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