Myocardial Ischemia Presenting with Hiccups.

Myocardial infarction/ischemia can be an underlying etiology and a major causative risk factor of cardiovascular hiccups. The objective of this systematic review was to review the literature regarding clinical features and treatments of hiccups of cardiac ischemia origin. PRISMA guidelines were followed. In elderly patients with hiccups of uncertain causes, electrocardiography is necessary to ensure the cardiogenic etiology. Both symptomatic and etiologic treatments can be effective in terminating hiccups. Of the therapeutic regimens, gabapentin is a second-line agent alternative to baclofen in treating hiccups. It is especially helpful in patients undergoing stroke rehabilitation or palliative care when chlorpromazine is prohibited due to its adverse effects. Inferior myocardial infarction is the most common cause of hiccups in this patient setting. In addition to anti-myocardial ischemia agents and percutaneous coronary intervention, coronary artery bypass grafting could be an alternative to hiccups in such patients.