Simple self-help maneuvers are effective in aborting vasovagal syncope.

Aborting Vasovagal Syncope To the Editor: The recent article by Lu et al1 reminded us of the frequency of vasovagal syncope (neurally mediated syncope) in the general population—22%. Although effective therapy, both pharmacologically and with a pacemaker, is now available,2 prevention is still the best recourse. Because vasovagal syncope is preceded by prodromal symptoms in two thirds of cases,3 there should be time to apply preventive measures. Recently, it has been shown that such simple self-help maneuvers as isometric arm contraction4 and leg crossing and muscle tensing,5 all of which work by increasing systemic blood pressures, could either postpone or prevent vasovagal syncope. Additionally, water ingestion, as reported by Lu et al,1 increases peripheral vascular resistance. The knowledge that such simple self-help maneuvers are readily available and could be lifesaving should prove valuable and helpful in everyday life. These self-help maneuvers are particularly relevant in preventing automobile accidents resulting from vasovagal syncope.6 As the saying goes, an ounce of prevention is worth a pound of cure.