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<p>Tapia’s syndrome is a rare postoperative complication involving concurrent injury to the vagus (cranial nerve X) and hypoglossal (cranial nerve XII) nerves, typically presenting with dysphagia, dysphonia, and tongue deviation. It is infrequently reported following cardiac surgery. We report a 43-year-old male who developed Tapia’s syndrome following elective coronary artery bypass grafting (CABG). Post-extubation, the patient experienced dysphagia-induced coughing episodes that triggered transient asystole, likely due to exaggerated vagal stimulation. Clinical evaluation revealed left vocal cord palsy and tongue deviation. Conservative management, including nasogastric feeding, vitamin B supplementation, and swallowing rehabilitation, led to significant recovery within 2 weeks. This case underscores the importance of recognizing Tapia’s syndrome as a potential postoperative complication in cardiac surgery. It also highlights the rare but serious risk of vagally mediated cardiac arrhythmias in such patients. Early diagnosis and multidisciplinary management are essential for optimal outcomes.</p>

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Tapia’s syndrome post-CABG: Unveiling the vagal mystery behind dysphagia and asystole

  • 期刊论文

  • 发表日期：

    2025年11月22日

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  • Vimal Varma Spor Madiman,
  • Ivy Sim Chui Geok,
  • Isqandar Adnan,
  • Mardhiah Sarah Harnani Mansor,
  • Akmal Firdaus Samuel,
  • Mohd Asyraf Jali,
  • Nik Nadhirah Nik Mohd Nasir

摘要

Tapia’s syndrome is a rare postoperative complication involving concurrent injury to the vagus (cranial nerve X) and hypoglossal (cranial nerve XII) nerves, typically presenting with dysphagia, dysphonia, and tongue deviation. It is infrequently reported following cardiac surgery. We report a 43-year-old male who developed Tapia’s syndrome following elective coronary artery bypass grafting (CABG). Post-extubation, the patient experienced dysphagia-induced coughing episodes that triggered transient asystole, likely due to exaggerated vagal stimulation. Clinical evaluation revealed left vocal cord palsy and tongue deviation. Conservative management, including nasogastric feeding, vitamin B supplementation, and swallowing rehabilitation, led to significant recovery within 2 weeks. This case underscores the importance of recognizing Tapia’s syndrome as a potential postoperative complication in cardiac surgery. It also highlights the rare but serious risk of vagally mediated cardiac arrhythmias in such patients. Early diagnosis and multidisciplinary management are essential for optimal outcomes.