This is the first study of its kind to document the effectiveness of a simple maneuver to prevent or delay loss of consciousness. The counter-maneuver could prove a simple, inexpensive alternative to medication or pacemaker implantation, says study senior author Wouter Wieling, M.D., Ph.D. associate professor of internal medicine and head of the syncope unit at the Academic Medical Center of the University of Amsterdam, the Netherlands.

Vasovagal syncope, or fainting, results from a neurological reflex that originates in the brain. In response to a physical or emotional trigger, the brain emits signals that cause blood vessels to dilate and causes blood to pool in the legs. The heart rate also slows. Subsequently, the brain does not receive enough oxygen-carrying blood, leading to fainting.

Standard treatment includes educating patients about the causes of the condition, instructing them how to avoid situations that trigger fainting, and maintaining adequate salt and fluid intake. Several drugs have been studied as treatment, but results have been inconsistent.

"Leg muscle crossing and tensing should be part of an intense nonpharmacological regimen for patients with vasovagal faints," says Wieling.

Physical counter-maneuvers such as leg crossing and muscle tensing have been developed in patients with low blood pressure when rising from a reclining position (orthostatic hypotension) a condition caused by rare diseases of the autonomic nervous system. Wieling and colleagues in Amsterdam and the United States theorized that the same maneuvers might help people who have vasovagal syncope.

The researchers ev
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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
2-Sep-2002