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Correspondence
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Volume 341:1316-1317 October 21, 1999 Number 17
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More on Deglutition Syncope

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To the Editor: In his letter to the editor (June 24 issue),1 Dr. Olshansky correctly asserts that deglutition syncope is classically associated with intense vagal afferent activation and bradycardia. We believe, however, that intense afferent vagal activation and bradycardia do not have to be present in order for the syndrome to occur.

An 86-year-old woman with postural hypotension and long-standing achalasia, who required a Heller's cardiomyotomy years previously, had a three-month history of dizziness, nausea, and diaphoresis after swallowing food and liquids. Two hours after she had breakfast, we asked her to swallow ice water while undergoing electrocardiography to monitor . . . [Full Text of this Article]

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