Immersion and venous occlusion plethysmography in patients with idiopathic orthostatic hypotension

In 3 patients suffering from idiopathic orthostatic hypotension (Shy-Drager's syndrome) venous distensibility was measured by occlusion plethysmography in supine and upright position. In this latter position, venoconstriction was absent, contrasting with the marked venoconstriction observed in normal volunteers studied under identical conditions. Venous occlusion plethysmography therefore seems to be useful to detect the autonomic defect leading to venous pooling. These patients were also immersed in water to the mid-abdomen while standing. This maneuver fully abolished orthostatic hypotension. Immersion is useful in motivating these patients to accept treatment by counterpressure garments, and makes early active physiotherapy possible.