Why the study?
Does dynamic tension improve hemodynamics and symptoms in a patient with prolonged post-faint hypotension?
Does dynamic tension improve hemodynamics and symptoms in a patient with prolonged post-faint hypotension?
Active leg flexion and extension (dynamic tension) can rapidly reverse prolonged post-faint hypotension by increasing venous return and stimulating central sympathetic pathways.
May support dynamic leg exercise in post-faint hypotension; leaves open generalizability beyond this single case.
A severe variant of vasovagal syncope, observed during tilt tests and blood donation has recently been termed "prolonged post-faint hypotension" (PPFH). A 49-year-old male with a life-long history of severe fainting attacks underwent head-up tilt for 20 min, and developed syncope 2 min after nitroglycerine spray. He was unconscious for 40 s and asystolic for 22 s. For the first 2 min of recovery, BP and HR remained low (65/45 mmHg and 40 beats/min) despite passive leg-raising. Blood pressure (and symptoms) only improved following active bilateral leg flexion and extension ("dynamic tension"). During PPFH, when vagal activity is extreme, patients may require central stimulation as well as correction of venous return.
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Wieling et al. (2011) studied this question.
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