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Europace 2005 7(1):25-27; doi:10.1016/j.eupc.2004.05.009
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© 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.

CASE REPORT

Orthostatic blood pressure control in Marfan's syndrome

Nynke van Dijka, Rogier V. Imminkb, Barbara J.M. Mulderc, Johannes J. van Lieshouta and Wouter Wielinga,*

aDepartment of Internal Medicine F4-222, Academic Medical Center Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; bDepartment of Physiology, Academic Medical Center Amsterdam, The Netherlands; cDepartment of Cardiology, Academic Medical Center Amsterdam, The Netherlands

A 33-year old male patient, with Marfan's syndrome, reported symptoms of orthostatic intolerance and fatigue as a longstanding problem. Orthostatic cardiovascular examination showed poor orthostatic tolerance, with a rise in heart rate and a fall in arterial blood pressure and cerebral blood flow velocity. Self-discovered physical counterpressure manoeuvers improved symptoms, related to a substantial increase in arterial pressure and cerebral perfusion. When orthostatic complaints are reported by patients with Marfan's syndrome, physical counterpressure manoeuvers should be advised to reduce symptoms of postural hypotension.

Key Words: Marfan's syndrome, orthostatic hypotension, physical counterpressure manoeuvers, cerebral blood flow velocity

*Corresponding author. Tel.: +31 205663161; fax: +31 206919658. E-mail address: w.wieling{at}amc.uva.nl (W. Wieling).


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