Usefulness of Squatting Combined with the Blood Pressure Measurement for Orthostatic Intolerance in Dizziness Clinic |
Hoseong Seo1, Sooyoung Kim1,2, Eun Hee Sohn1, Seong-Hae Jeong1 |
1Department of Neurology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea 2Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea |
기립불능증에서 기립경사 검사와 웅크림 혈압 측정의 유용성 |
서호성1, 김수영1,2, 손은희1, 정성해1 |
1충남대학교 의과대학 충남대학교병원 신경과 2분당서울대학교병원 신경과 |
Correspondence:
Seong-Hae Jeong, Tel: +82-42-280-8057, Fax: +82-42-252-8654, Email: mseaj1081@gmail.com |
Received: 11 October 2020 • Revised: 10 December 2020 • Accepted: 15 December 2020 |
Abstract |
Background Orthostatic intolerance (OI) is a common clinical symptom in dizziness clinic. The head-up tilt table test (HUT) is one of the primary clinical examination for evaluating OI. There is no consensus on the optimum method for diagnosis of orthostatic hypotension (OH). Herein, we performed the additional squat combined with blood pressure (BP) monitoring for OI patients with normal HUT.
Methods The study included 32 consecutive patients with orthostatic intolerance for 3 months since April, 2018 (Period I) and 27 patients with orthostatic intolerance for 3 months since April, 2019 (Period II) in dizziness clinic of Chungnam National University Hospital. During Period II, the additional squat combined with BP test was performed for normal HUT results in patients with OI. In squat combined orthostatic BP measurement, the first BP measurement was taken following 3 minutes of rest at the squat position; afterwards the patients were raised upright and the measurement was monitored for 2 minutes, using a continuous beat-to-beat BP monitoring.
Results In this study, there was significant difference in OH diagnosis (p<0.001); 40.6% (13/32) by conventional HUT (Period I) vs. 92.5% (25/33) by conventional HUT and additional squat test for normal HUT (Period II). In patients with normal HUT, the positive OH was 86.7% (13/15) by the additional squat combined BP measurement (Period II).
Conclusions In addition to HUT, squat test combined with BP measurement might be more informative for understanding and diagnosing the OH, particularly in patients with OI and normal HUT in dizziness clinic. |
Key Words:
Orthostatic intolerance, Tilt table test |
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