The clinically important upper gastrointestinal-cardiac vagovagal reflexes are mainly those initiated by swallowing and rapid gastric distention. Pre-existing-heart disease has little to do with determining susceptibility to upper gastrointestinal stimuli. The dangerous cardiac repercussions concern diminished coronary artery flow and the arrhythmias. The latter can be subcategorized as swallow tachycardia, pharyngeal disease with arrhythmia, glossopharyngeal neuralgia with swallow syncope, spontaneous swallow syncope and swallow bradycardia. Iatrogenic arrhythmias are particularly tragic potential hazards of all pharyngoesophagogastric manipulations.