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Isometric Arm Contraction at the Onset of Prodromal Symptoms: a New First-line Treatment for Vasovagal Syncope?

  • M. Brignole
  • F. Croci
  • C. Menozzi
  • A. Solano
  • P. Donateo
  • D. Oddone
  • E. Puggioni
  • G. Lolli
Conference paper

Abstract

Vasovagal syncope is preceded by prodromal symptoms in about two-thirds of cases [1]. Prodromal symptoms are present in virtually all cases of tilt-induced vasovagal syncope, which occurs, on average, 1 minute after the onset of the prodromal symptoms [2]. During the prodromal phase, blood pressure falls markedly; this fall usually precedes the decrease in heart rate, which may be absent at least at the beginning of this phase [2, 3]. Hypotension is caused by vasodilatation in the skeletal muscles owing to the inhibition of sympathetic vasoconstrictive activity [2, 4–7]. Two recent clinical trials [8, 9] have shown that isometric maneuvers involving the legs or the arms can induce a significant increase in blood pressure during the phase of impending vasovagal syncope and allow the patient to avoid or at least delay the loss of consciousness in most cases. This effect seems to be mediated largely by sympathetic nerve discharge and vascular resistance increase during the maneuvers.

Keywords

Maximal Voluntary Contraction Autonomic Failure Prodromal Symptom Vasovagal Syncope Muscle Tensing 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Italia 2004

Authors and Affiliations

  • M. Brignole
    • 1
  • F. Croci
    • 1
  • C. Menozzi
    • 2
  • A. Solano
    • 1
  • P. Donateo
    • 1
  • D. Oddone
    • 1
  • E. Puggioni
    • 1
  • G. Lolli
    • 2
  1. 1.Department of Cardiology, Arrhythmologic CentreOspedali del TigullioItaly
  2. 2.Service of Interventional Cardiology, Department of CardiologyOspedale S Maria NuovaReggio EmiliaItaly

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