Differential Diagnosis for a Patient who Passes Out while Eating
Single Most Likely Diagnosis
- Vasovagal Syncope: This is the most common cause of fainting while eating, often triggered by the sight, smell, or taste of food, leading to a vagal nerve response that causes a sudden drop in blood pressure and heart rate.
Other Likely Diagnoses
- Orthostatic Hypothermia: Dehydration or low blood volume can cause a drop in blood pressure when standing up from eating, leading to fainting.
- Postprandial Hypothermia: Eating a large meal can cause blood to flow to the digestive system, leading to a drop in blood pressure and fainting.
- Gastroesophageal Reflux: Severe reflux can cause pain and lead to a vagal response, resulting in fainting.
Do Not Miss Diagnoses
- Myocardial Infarction: A heart attack can cause fainting, especially if it occurs during physical activity like eating.
- Cerebrovascular Accident (CVA): A stroke can cause fainting, especially if it affects the brainstem or cerebellum.
- Anaphylaxis: A severe allergic reaction to food can cause fainting, along with other symptoms like hives, swelling, and difficulty breathing.
- Pulmonary Embolism: A blood clot in the lungs can cause fainting, especially if it occurs suddenly and without warning.
Rare Diagnoses
- Nutcrorpion: A rare condition where the esophagus is compressed by the aorta, leading to fainting and other symptoms while eating.
- Eating-Induced Angioedema: A rare condition where eating certain foods triggers an allergic reaction, leading to swelling and fainting.
- Chagas Disease: A rare parasitic infection that can cause fainting and other symptoms, especially after eating.
- Hypotharmonic Shock: A rare condition where the body's temperature regulation is disrupted, leading to fainting and other symptoms while eating.