Referred Vagal Reflexes
Authors: Alexander C. Chester
Journal: Annals of Internal Medicine (1992)

Letters1 September 1992Referred Vagal ReflexesAlexander C. Chester, MDAlexander C. Chester, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-5-444 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: Cunningham and colleagues (1), in their review of vagal reflexes from the upper aerodigestive tract, concluded that a vagal origin of otherwise unexplained cardiorespiratory symptoms should be considered. Omitted from their discussion, however, was a large body of pertinent experimental, clinical, and historical data from a much earlier era, describing virtually identical vagal reflexes.Kratschmer (1870) first documented heart rate and blood pressure changes triggered by nasal irritation. Later, clinicians observed the resolution of systemic symptoms, especially palpitations and chest complaints, with nasal surgery or cauterization. Neurasthenia, a condition characterized by palpitations, chest pain, and fatigue, was...References1. Cunningham E, Ravich W, Jones B, and Donner M. Vagal reflexes referred from the upper aerodigestive tract: an infrequently recognized cause of common cardiorespiratory responses. Ann Intern Med. 1992;116:575-82. LinkGoogle Scholar2. White J. Neuroses of the nose and naso-pharynx. In: Burnett CH; ed. System of Diseases of the Ear, Nose, and Throat. Vol 2. Philadelphia: J.B. Lippincott; 1893:90-148. Google Scholar3. Freud S. The Complete Letters of Sigmund Freud to Wilhelm Fliess 1887-1904. Cambridge, Massachusetts: Harvard University Press; 1985:130. Google Scholar4. Widdicombe J. Reflexes from the upper respiratory tract. In: Cherniack NS, Widdicombe JG; eds. Handbook of Physiology: The Respiratory System II. Bethesda, Maryland: The American Physiological Society; 1986:363-94. CrossrefGoogle Scholar5. Wolf S. Psychophysiological influences on the dive reflex in man. In: Schwartz PJ, Brown AM, Malliani A, Zanchetti A; eds. Neural Mechanisms in Cardiac Arrhythmias. New York: Raven Press; 1978:237-50. Google Scholar1. Cunningham E, Ravich W, Jones B, and Donner M. Vagal reflexes referred from the upper aerodigestive tract: an infrequently recognized cause of common cardiorespiratory responses. Ann Intern Med. 1992;116:575-82. LinkGoogle Scholar1. Proctor D and Andersen I eds. The Nose: Upper Airway Physiology and the Atmospheric Environment. Amsterdam: Elsevier; 1982. Google Scholar2. Alexander J. Reflex disturbances of cardiac rhythm during ophthalmic surgery. Br J Ophthalmol. 1975;59:518-24. CrossrefMedlineGoogle Scholar3. Lang S, Lanigan D, and van der Wal M. Trigeminocardiac reflexes: maxillary and mandibular variants of the oculocardiac reflex. Can J Anaesth. 1991;38:757-60. CrossrefMedlineGoogle Scholar4. Norgren R. Central neural mechanisms of taste. In: Handbook of Physiology. Bethesda, Maryland: The American Physiological Society; 1984:1087-124. Google Scholar5. Kolodzik P and Eilers M. Hiccups (singultus): review and approach to management. Ann Emerg Med. 1991;20:135-43. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Alexander C. Chester, MDAffiliations: Georgetown University Medical Center Washington, D.C. 20007 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1992Volume 117, Issue 5Page: 444-445KeywordsBlood pressureFatigueHeart rateIschemiaReflexesSurgeryThorax ePublished: 1 December 2008 Issue Published: 1 September 1992 PDF downloadLoading ...