Usefulness of physical maneuvers for prevention of vasovagal syncope

Kye Hun Kim, Gwan Cho Jeong, Ok Lee Kyung, Jin Seo Tae, Young Shon Chang, Sang Yeob Lim, Ho Yun Kyung, Suk Sohn Il, Joon Hong Young, Wook Park Hyung, Han Kim Ju, Weon Kim, Keun Ahn Young, Ho Jeong Myung, Chun Park Jong, Chaee Kang Jung

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: It is known that approximately two-thirds of patients with vasovagal syncope have prodromal symptoms and when these start, physical maneuvers that can increase venous return may abort the syncopal attack. The aims of this study were to evaluate the effects of 3 physical maneuvers, squatting, leg-crossing with muscle tensing, and handgrip, on improving hemodynamic status, and to compare the effect of each on aborting or preventing vasovagal syncope. Methods and Results: Of 50 patients who underwent the head-up tilt test (HUT) to evaluate syncope, 27 patients with positive HUT were classified as group I (14 men, 13 women; mean age 44.5±15.3 years), 23 patients with negative HUT were classified as group II (13 men, 10 women; mean age 41.2±16.7 years), and 21 normal subjects were classified as group III (10 men, 11 women; mean age 28.6±6.3 years). The effects of the physical maneuvers were evaluated in 21 patients from group I who underwent a repeat HUT 1 week after the initial test. Leg-crossing significantly increased systolic blood pressure (SBP) in all 3 groups (8.0±5.8 mmHg in group I, 7.0±8.5 mmHg in group II, 8.7±5.7 mmHg in group III; p<0.05), but not diastolic blood pressure (DBP). Squatting significantly increased SBP and DBP in all 3 groups (7.1±5.1, 4.6±5.8 mmHg in group I, 7.8±5.9, 4.3±4.7 mmHg in group II, 6.5±5.0, 3.7±3.9 mmHg in group III; p<0.05). However, handgrip did not exert any significant influence on the hemodynamics in any group nor did heart rate change significantly during the physical maneuvers in any group. During the repeat HUT, prodromal symptoms with hypotension developed in 13 of the 21 patients and of these 5 fainted immediately after and were not able to do the physical maneuvers. Squatting and leg-crossing aborted syncope in 7 of 8 patients, but handgrip aborted syncope in only 1 patient. Conclusion: Squatting and leg-crossing with muscle tensing improved the hemodynamics of normal subjects as well as those of patients with vasovagal syncope. Squatting and leg-crossing can be used as a simple and effective preventive maneuver in patients with vasovagal syncope.

Original languageEnglish
Pages (from-to)1084-1088
Number of pages5
JournalCirculation Journal
Volume69
Issue number9
DOIs
Publication statusPublished - 2005 Sep 1
Externally publishedYes

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Vasovagal Syncope
Blood Pressure
Leg
Head
Syncope
Prodromal Symptoms
Hemodynamics
Muscles
Hypotension
Heart Rate

Keywords

  • Hemodynamics
  • Physical maneuver
  • Syncope

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, K. H., Jeong, G. C., Kyung, O. L., Tae, J. S., Chang, Y. S., Lim, S. Y., ... Jung, C. K. (2005). Usefulness of physical maneuvers for prevention of vasovagal syncope. Circulation Journal, 69(9), 1084-1088. https://doi.org/10.1253/circj.69.1084

Usefulness of physical maneuvers for prevention of vasovagal syncope. / Kim, Kye Hun; Jeong, Gwan Cho; Kyung, Ok Lee; Tae, Jin Seo; Chang, Young Shon; Lim, Sang Yeob; Kyung, Ho Yun; Il, Suk Sohn; Young, Joon Hong; Hyung, Wook Park; Ju, Han Kim; Kim, Weon; Young, Keun Ahn; Myung, Ho Jeong; Jong, Chun Park; Jung, Chaee Kang.

In: Circulation Journal, Vol. 69, No. 9, 01.09.2005, p. 1084-1088.

Research output: Contribution to journalArticle

Kim, KH, Jeong, GC, Kyung, OL, Tae, JS, Chang, YS, Lim, SY, Kyung, HY, Il, SS, Young, JH, Hyung, WP, Ju, HK, Kim, W, Young, KA, Myung, HJ, Jong, CP & Jung, CK 2005, 'Usefulness of physical maneuvers for prevention of vasovagal syncope', Circulation Journal, vol. 69, no. 9, pp. 1084-1088. https://doi.org/10.1253/circj.69.1084
Kim, Kye Hun ; Jeong, Gwan Cho ; Kyung, Ok Lee ; Tae, Jin Seo ; Chang, Young Shon ; Lim, Sang Yeob ; Kyung, Ho Yun ; Il, Suk Sohn ; Young, Joon Hong ; Hyung, Wook Park ; Ju, Han Kim ; Kim, Weon ; Young, Keun Ahn ; Myung, Ho Jeong ; Jong, Chun Park ; Jung, Chaee Kang. / Usefulness of physical maneuvers for prevention of vasovagal syncope. In: Circulation Journal. 2005 ; Vol. 69, No. 9. pp. 1084-1088.
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AU - Jeong, Gwan Cho

AU - Kyung, Ok Lee

AU - Tae, Jin Seo

AU - Chang, Young Shon

AU - Lim, Sang Yeob

AU - Kyung, Ho Yun

AU - Il, Suk Sohn

AU - Young, Joon Hong

AU - Hyung, Wook Park

AU - Ju, Han Kim

AU - Kim, Weon

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AU - Myung, Ho Jeong

AU - Jong, Chun Park

AU - Jung, Chaee Kang

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KW - Physical maneuver

KW - Syncope

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