Main description:

Vasovagal syncope ("the common faint") and near syncope from initial orthostatic hypotension are huge medical problems given the number of patients and their impact on quality of life. The treatment options are often unsatisfactory. The studies in this thesis set out to investigate the potential benefits of physical counter-manoeuvres in the acute management of vasovagal syncope and initial orthostatic hypotension. Once shown to be effective, further studies elucidated how they work.

Contents:

Contents - 6 Acknowledgements - 8 Co-authors and their Current Affiliations - 10 1. Introduction - 12 2. Management of Vasovagal Syncope: Controlling or Aborting Faints by Leg Crossing and Muscle Tensing - 28 3. Leg Crossing, Muscle Tensing, Squatting and the "Crash-position" are Effective Against Vasovagal Reactions Through Increases in Cardiac Output - 40 4. Leg Crossing Improves Orthostatic Tolerance in Healthy Subjects: a Placebo Controlled Cross-over Study - 52 5. Lower Body Muscle Tensing Diminishes the Blood Pressure Decrease Upon Standing From Squatting in the Post-vasovagal State - 62 6. Management of Initial Orthostatic Hypotension: Lower Body Muscle Tensing Attenuates The Transient Arterial Blood Pressure Decrease Upon Standing From Squatting - 74 7. Conclusions - 84 Samenvatting (Dutch Summary) - 88 References - 92 Abbreviations - 110