Unusual swallow syncope caused by huge hiatal hernia

Abstract

Swallowing is a rare cause of syncope. A 76-year-old woman was admitted to a hospital due to postprandial loss of consciousness. Although no remarkable cardiogenic problem was proven, upper gastrointestinal barium examination revealed a huge hiatal hernia. Both echocardiography and MRI presented the collapsed left atrium due to the herniated stomach. Water pouring examination successfully represented lightheadedness, and Nissen's fundoplication was carried out. After this procedure, she never suffered from syncopal attack.