Alexander C. Chester, MD
To 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
Chester AC. Referred Vagal Reflexes. Ann Intern Med. ;117:444–445. doi: 10.7326/0003-4819-117-5-444
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Published: Ann Intern Med. 1992;117(5):444-445.
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