Hand-grip maneuver primarily increases afterload, causing what happens to LV blood?

• A. Increases afterload, increases LV blood remaining
• B. Increases preload directly
• C. Decreases afterload
• D. Decreases LV blood remaining

Answer: (A)

When the hand-grip maneuver is used, it increases afterload by raising systemic vascular resistance and aortic pressure. The left ventricle has to push against this higher pressure during systole. If contractility and preload stay the same, the ventricle ejects less blood each beat, so the amount of blood left in the ventricle at the end of systole—the end-systolic volume—rises. In short, higher afterload leads to more LV blood remaining after contraction. Preload isn’t directly increased by this maneuver, and afterload isn’t decreased, so the outcome is an increase in LV blood remaining.