Monday, December 22, 2008

Dangerous Sandwiches

The "Enormous Omelet Sandwich" - 730 calories and 47 grams of fat

The "Monster Thickburger" - 1,420 calories and 107 grams of fat

The Ultimate Bacon Sandwich - 22 slices (1.25 lbs)

The 30,000 Calorie Sandwich (self-explanatory)

And now from The Lancet:
Dangerous Sandwiches

The unusual case of a woman who regularly fainted while eating sandwiches or fizzy drinks is explored in a Case Report in this week’s edition of The Lancet...

The 25-year-old woman was seen at the hospital in January this year. She presented with episodes, typically lasting 10 second or less, of feeling suddenly and alarmingly light headed, and nauseous. She had collapsed on more than one occasion, but had no movements typical of epilepsy. Sometimes she would have several episodes a week. The problem first began when she was 15 and remained unexplained despite hospital admissions between 2001 and 2007. A full battery of blood and other tests had, more than once, revealed everything to be normal. However, an electrocardiogram (ECG) test had shown a pause of 2.5 seconds. She then had external-loop ECG tests, in which she was asked to press a button to record 1-2 minutes of the ECG each time she felt faint. At times of light-headedness, she was found to have complete atrioventricular block (a slowing of intracardiac conduction), with beat-to-beat pauses lasting up to 2.5 seconds.
This was due to a rare case of swallow syncope (see also Armstrong et al., 1985 and Siegel, 2007)...
...a transient alteration or loss of consciousness during swallowing, and is usually intermittent. It may be caused by altered feedback in vagal reflexes—in which the afferent pathway, from the oesophagus, terminates in the nucleus tractus solitarius, and the efferent pathway runs from the medulla to the heart—or by vagal hypersensitivity.
After the patient was fitted with a pacemaker, her fainting episodes ceased and
When last seen, in June, 2008, she could eat sandwiches with impunity.
Let's hope she didn't choose the "Monster Thickberger"...


Christopher John Boos, Una Martin, Russell C Cherry, Howard J Marshall (2008). Dangerous sandwiches. The Lancet 372:2164.

I am making the most dangerous sandwich possible......with science!

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