Syncope is a clinical syndrome in which transient loss of consciousness (TLOC) is caused by a period of inadequate cerebral nutrient flow, most often the result of an abrupt drop of systemic blood pressure. For patients with recurrent vasovagal syncope and prodromal symptoms, physical isometric counter pressure maneuvers such as leg-crossing and/or lower body muscle tensing is recommend. These should be initiated upon first recognition of premonitory symptoms.
Isometric activity, such as crossing the legs and the arms, may be helpful to offset a syncopal response, but release of this position may be associated with precipitous decline in heart rate and blood pressure. Counter-pressure maneuvers, such as tensing the arms with clenched fists, leg pumping, and leg-crossing, may abort a syncopal episode or at least delay it long enough that patients can assume the supine position .…
