{{Short description|Performed by clenching one's fist forcefully for a sustained time until fatigued}} {{Use American English|date=March 2021}} {{Use mdy dates|date=March 2021}}
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.{{cn|date=January 2022}}
== Physiological response == The handgrip maneuver increases afterload<ref>{{Citation |last=Thomas |first=Seth L. |title=Physiology, Cardiovascular Murmurs |date=2023 |url=https://www.ncbi.nlm.nih.gov/books/NBK525958/ |work=StatPearls |access-date=2023-10-26 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=30247833 |last2=Heaton |first2=Joseph |last3=Makaryus |first3=Amgad N.}}</ref> by squeezing the arterioles and increasing total peripheral resistance.<ref>{{cite journal |doi=10.1152/ajpheart.00334.2009 |pmid=19966060 |title=Arterial pulsatile hemodynamic load induced by isometric exercise strongly predicts left ventricular mass in hypertension |journal=American Journal of Physiology. Heart and Circulatory Physiology |volume=298 |issue=2 |pages=H320–H330 |year=2010 |last1=Chirinos |first1=Julio A |last2=Segers |first2=Patrick |last3=Raina |first3=Amresh |last4=Saif |first4=Hassam |last5=Swillens |first5=Abigail |last6=Gupta |first6=Amit K |last7=Townsend |first7=Raymond |last8=Emmi |first8=Anthony G |last9=Kirkpatrick |first9=James N |last10=Keane |first10=Martin G |last11=Ferrari |first11=Victor A |last12=Wiegers |first12=Susan E |last13=St. John Sutton |first13=Martin G |s2cid=1191870 }}</ref>
== 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.<ref name=pmid5064766>{{cite journal |doi=10.1136/hrt.34.6.605 |pmid=5064766 |pmc=458507 |title=Response of heart murmur intensity to isometric (handgrip) exercise |journal=Heart |volume=34 |issue=6 |pages=605–10 |year=1972 |last1=McCraw |first1=D B |last2=Siegel |first2=W |last3=Stonecipher |first3=H K |last4=Nutter |first4=D O |last5=Schlant |first5=R C |last6=Hurst |first6=J W }}</ref> This includes aortic regurgitation (AR), mitral regurgitation (MR), and a ventricular septal defect (VSD).<ref name="auto">{{cite web | url= https://www.lecturio.com/concepts/aortic-regurgitation/ | title= Aortic Regurgitation | website= The Lecturio Medical Concept Library | date= October 2020 | access-date= 29 June 2021}}</ref>
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.<ref name="Tanser">Tanser, Paul H. (reviewed Mar 2007). [http://www.merckmanuals.com/professional/sec07/ch076/ch076d.html "Mitral Valve Prolapse"], ''[http://www.merckmanuals.com/professional/index.html The Merck Manuals Online Medical Library]'', Retrieved 2011-01-08.</ref>
Murmurs that are due to forward flowing of blood such as aortic stenosis, and hypertrophic cardiomyopathy decrease in intensity.<ref name="auto"/>
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.<ref>{{Cite web|date=2018-06-28|title=Aortic Stenosis - Cardiovascular Disorders - Merck Manuals Professional Edition|url=https://www.merckmanuals.com/professional/cardiovascular-disorders/valvular-disorders/aortic-stenosis|access-date=2021-08-16|archive-url=https://web.archive.org/web/20180628015536/https://www.merckmanuals.com/professional/cardiovascular-disorders/valvular-disorders/aortic-stenosis|archive-date=June 28, 2018}}</ref> A complementary maneuver for differentiating disorders is the Valsalva maneuver, which decreases preload.<ref>{{cite journal |last=Taylor |first=D |title=The Valsalva Manoeuvre: A critical review |journal=South Pacific Underwater Medicine Society Journal |volume=26 |issue=1 |year=1996 |issn=0813-1988 |oclc=16986801 |url=http://archive.rubicon-foundation.org/6264 |archive-url=https://web.archive.org/web/20080508210947/http://archive.rubicon-foundation.org/6264 |url-status=usurped |archive-date=May 8, 2008 |access-date= 29 June 2021}}</ref> {| class="wikitable" |- ! Handgripping maneuver !! Cardiac Finding |- | rowspan=3 | '''Increased murmur intensity ''' | Aortic regurgitation |- | Mitral regurgitation |- | Ventricular septal defect |-
|- | rowspan="4" | '''Decreased murmur intensity''' | Aortic stenosis |- | Hypertrophic cardiomyopathy
|}
== See also == * Valsalva maneuver * Preload * Afterload
== References == {{Reflist}}
Category:Cardiac procedures