Английская Википедия:Handgrip maneuver

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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.Шаблон:Cn

Physiological response

The handgrip maneuver increases afterload[1] by squeezing the arterioles and increasing total peripheral resistance.[2]

Cardiology

Since increasing afterload will prevent blood from flowing in a normal forward path, it will increase any murmurs that are due to backwards flowing blood.[3] This includes aortic regurgitation (AR), mitral regurgitation (MR), and a ventricular septal defect (VSD).[4]

Mitral valve prolapse: The click and the murmur of mitral valve prolapse are delayed because left atrial volume also increases due to mitral regurgitation along with increased left ventricular volume.[5]

Murmurs that are due to forward flowing of blood such as aortic stenosis, and hypertrophic cardiomyopathy decrease in intensity.[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.[6] A complementary maneuver for differentiating disorders is the Valsalva maneuver, which decreases preload.[7]

Handgripping maneuver Cardiac Finding
Increased murmur intensity Aortic regurgitation
Mitral regurgitation
Ventricular septal defect
Decreased murmur intensity Aortic stenosis
Hypertrophic cardiomyopathy

See also

References

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