Usefulness of Squatting Combined with the Blood Pressure Measurement for Orthostatic Intolerance in Dizziness Clinic

Seo, Hoseong; Kim, Sooyoung; Sohn, Eun Hee; Jeong, Seong-Hae

doi:2020.12.2.32

Korean J Neuromuscul Disord > Volume 12(2); 2020 > Article

Original Article

Korean Journal of Neuromuscular Disorders 2020;12(2):32-35.
DOI: https://doi.org/10.46518/kjnmd.2020.12.2.32 Published online December 31, 2020.

Usefulness of Squatting Combined with the Blood Pressure Measurement for Orthostatic Intolerance in Dizziness Clinic

Hoseong Seo¹, Sooyoung Kim^1,2, 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, 김수영^1,2, 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