| 词条 | Handgrip maneuver | |||||||||
| 释义 |
The handgrip maneuver is performed by clenching one's fist forcefully for a sustained time until fatigued. Variations include squeezing an item such as a rolled up washcloth. Physiological ResponseThe handgrip maneuver increases afterload by squeezing the arterioles and increasing total peripheral resistance.[1] CardiologySince increasing after load will prevent blood from flowing in a normal forward path, it will increase any murmurs that are due to backwards flowing blood.[2] This includes aortic regurgitation (AR), mitral regurgitation (MR), and a ventricular septal defect (VSD). Mitral valve prolapse: The click and the murmur of mitral valve prolapse are delayed because left atrial volume also increases due to mitral regurgitation alongwith increased left ventricular volume.[3]Murmurs that are due to forward flowing of blood such as aortic stenosis, and hypertrophic cardiomyopathy decrease in intensity. Mitral stenosis: The diastolic murmur of mitral stenosis decreases because it is a forward-flow murmur.[2][4]The effect of reducing the intensity in forward flowing murmurs is much more evident in aortic stenosis rather than mitral stenosis. The reason for this is that there is a larger pressure gradient across the aortic valve.[5] A complementary maneuver for differentiating disorders is the Valsalva maneuver, which decreases preload.
See also
References1. ^{{cite journal |doi=10.1152/ajpheart.00334.2009 |pmid=19966060 |title=Arterial pulsatile hemodynamic load induced by isometric exercise strongly predicts left ventricular mass in hypertension |journal=American Journal of Physiology. Heart and Circulatory Physiology |volume=298 |issue=2 |pages=H320–H330 |year=2010 |last1=Chirinos |first1=Julio A |last2=Segers |first2=Patrick |last3=Raina |first3=Amresh |last4=Saif |first4=Hassam |last5=Swillens |first5=Abigail |last6=Gupta |first6=Amit K |last7=Townsend |first7=Raymond |last8=Emmi |first8=Anthony G |last9=Kirkpatrick |first9=James N |last10=Keane |first10=Martin G |last11=Ferrari |first11=Victor A |last12=Wiegers |first12=Susan E |last13=St. John Sutton |first13=Martin G }} 2. ^1 {{cite journal |doi=10.1136/hrt.34.6.605 |pmid=5064766 |pmc=458507 |title=Response of heart murmur intensity to isometric (handgrip) exercise |journal=Heart |volume=34 |issue=6 |pages=605–10 |year=1972 |last1=McCraw |first1=D B |last2=Siegel |first2=W |last3=Stonecipher |first3=H K |last4=Nutter |first4=D O |last5=Schlant |first5=R C |last6=Hurst |first6=J W }} 3. ^Tanser, Paul H. (reviewed Mar 2007). "Mitral Valve Prolapse", The Merck Manuals Online Medical Library, Retrieved 2011-01-08. 4. ^{{cite web |url=http://cmbi.bjmu.edu.cn/uptodate/cardiac%20evaluation/Physiologic%20and%20pharmacologic%20maneuvers%20in%20the%20differential%20diagnosis%20of%20heart%20murmurs%20and%20sounds.htm |title=Physiologic and pharmacologic maneuvers in the differential diagnosis of heart murmurs and sounds |author=Kanu Chatterjee |date=May 9, 1999 |deadurl=yes |archiveurl=https://web.archive.org/web/20120615130208/http://cmbi.bjmu.edu.cn/uptodate/cardiac%20evaluation/Physiologic%20and%20pharmacologic%20maneuvers%20in%20the%20differential%20diagnosis%20of%20heart%20murmurs%20and%20sounds.htm |archivedate=June 15, 2012 |df= }} 5. ^http://www.merckmanuals.com/professional/sec07/ch076/ch076c.html{{full citation needed|date=August 2018}} 1 : Cardiac procedures |
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