Schellong test

The Schellong test , a medical diagnostic examination named after the internist Fritz Schellong (1891–1953), is a hemodynamic function test to diagnose primarily hypotonic (low blood pressure associated) circulatory regulation disorders.

The Schellong test is nowadays often replaced or supplemented by the tilt table examination .

background

When you get up from lying down, part of the blood is shifted to the lower extremities due to gravity. As a result, the higher organs, especially the brain , are less supplied with blood. The human body reacts spontaneously with an accelerated heartbeat and a contraction of the leg veins. This orthostatic reaction prevents symptoms such as dizziness and syncope , which occur when the blood supply to the brain is reduced.

procedure

Start of the examination after the patient has been in a relaxed lying position for 10 minutes.

1st part - measurements in a lying position Blood pressure and pulse are measured at
a fixed interval of one minute . Duration: 2 minutes.

2nd part - measurements in standing position
Immediately after the last lying measurement, blood pressure and pulse are measured while standing (immediate value). During the standstill period, the measurement is repeated at intervals of one minute. Duration: 10 minutes. Elderly people or anyone who has been in bed for a long time will find it difficult to complete this test. This should then lead to the termination of the test and be noted in the evaluation.

For easier evaluation, the measured values are usually displayed graphically.

evaluation

The values determined show whether and to what extent there is an effective orthostatic response. Special significance of the measured immediately after getting immediate value . Physiologically, immediately after getting up there is a slight drop in the systolic blood pressure value and an increase in the pulse rate of 10 to 20 beats per minute. Depending on the course of the pulse and blood pressure values, certain circulatory regulation disorders can be concluded. According to the current definition, a diagnosis of orthostatic hypotension (blood pressure that is too low when standing) is made if 1) the systolic blood pressure falls by at least 20 mmHg OR 2) the diastolic blood pressure falls by at least 10 mmHg, measured within 5 minutes of standing up. The examined person should have been lying quietly 5 minutes beforehand. On the other hand, an increase in the pulse by more than 30 beats per minute would indicate the so-called syndrome of postural tachycardia.

literature

Pschyrembel Clinical Dictionary. 260th edition
Print template Schellong test ( MS Word ; 90 kB)

Individual evidence

↑ ^a ^b Freeman R, Wieling W, Axelrod FB, et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res 2011; 21:69.

[:0-1] Freeman R, Wieling W, Axelrod FB, et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res 2011; 21:69.