Abstract

Acupuncture is a well-known alternative therapy in practice worldwide. Its dramatic effect on hiccups has been rarely reported. We describe a 77-year-old male who had hiccups after an acute myocardial infarction. Despite aggressive treatment including breath-holding to interrupt the respiratory rhythm, continuous positive airway pressure, and medication with metoclopramine, prochlorperazine, chlorpromazine, haloperidol, mephenesin, diphenylhydantoin, baclofen, and phenobarbital, the hiccups persisted for 7 days. Eventually, the hiccups were rapidly terminated by acupuncture at acupoint GV14 (Da zhui). To the best of our knowledge, this is the first report of acupuncture's reversing intractable hiccups after an acute myocardial infarction. Acupuncture may be considered for patients with hiccups refractory to conventional therapy.

Key Points

* Stimulation of the superficial and deep cardiac plexuses, which connect to the afferent limb of the hiccup reflex arc, caused by acute anterolateral myocardial infarction, can lead to persistent and intractable hiccups.

* Acupuncture can interrupt the hiccup reflex arc through activation of the autonomic nervous system, change of blood perfusion, inflammatory mediators, and neurotransmitters and neurohormones of the hiccup center.

* Acupuncture over the acupoint GV14 (Da zhui) can be considered as an effective alternative treatment for hiccups refractory to the conventional therapy.