Reflex Abdominal Syncope: A Case Series

The etiology of syncope in the acute care setting requires considerable input from numerous specialties. During a recent analysis of patients presenting to the acute care setting with syncope and identification of underlying associated disorders, we identified a subdiagnosis presenting with gastrointestinal associated bradycardia. We report here four cases of this syndrome, where exacerbation of abdominal pain was associated with bradycardia and subsequent syncope. Patients were evaluated with European Society of Cardiology-based standards, including cardiovascular and neurologic testing, which was unremarkable. Treatment of patients for their underlying gastrointestinal disorders (gastritis, gastroenteritis, diverticulitis) resulted in resolution of syncopal symptoms. Such reflex abdominal syncope should be considered in patients presenting to an acute care setting with abdominal pain and transient losses of consciousness.