Abstract

We studied the responses of six healthy volunteers to standard 70 degrees head-up tilt tests before exhaustive exercise of short duration (control) and after 5, 25, 50, 80, and 110 min of recovery, all tests lasting for 6 min except when impending syncope (IS) necessitated premature termination of a test. Marked impairment of orthostatic tolerance was apparent during the first half-hour of recovery as manifested by symptoms of IS in five subjects in one or both of the first two postexercise tilt tests. In none of the subjects who developed symptoms of IS did central venous pressure fall to a lower level than it did in the control test. From the central venous and arterial pressure reactions we conclude that when IS developed, declining systematic resistance rather than diminished cardiac filling was the responsive factor. The increased tendency for orthostatic collapse occurred during a period of recovery marked by persistent postexercise acidemia and hyperthermia suggesting interference of these conditions and associated events with the normal ability to vasoconstrict during orthostasis.

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