A Case of Syncope on Swallowing Secondary to Diffuse Oesophageal Spasm

A case of secondary vagal syncope elicited from the oesophagus is reported. Radiography and manometry revealed changes characteristic of diffuse oesophageal spasm. The intake of a granulate, which in the patient's experience could induce the attacks in a mild form, was found to elicit precordial pain, an abnormally high intraluminal pressure in the oesophagus, and atrio‐ventricular block. After being treated by oesophagomyotomy plus repair of a hiatal hernia the patient has not for 6 months had any pain from syncopal attacks.