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.
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© 2004 Springer-Verlag Italia
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Brignole, M. et al. (2004). Isometric Arm Contraction at the Onset of Prodromal Symptoms: a New First-line Treatment for Vasovagal Syncope?. In: Raviele, A. (eds) Cardiac Arrhythmias 2003. Springer, Milano. https://doi.org/10.1007/978-88-470-2137-2_84
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DOI: https://doi.org/10.1007/978-88-470-2137-2_84
Publisher Name: Springer, Milano
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