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Exertional hypotension is well described in quadraplegics, but there are few descriptions of this hemodynamic response in paraplegics or of treatment modalities to correct this condition. We describe a patient with a complete T3-4 spinal cord lesion who repeatedly demonstrated symptomatic hypotension with wheelchair sports and arm ergometry. We used gas exchange analysis and exercise echocardiography to delineate the mechanism for hypotension. These results enabled us to develop a simple treatment plan consisting of abdominal binding and elastic stockings to avoid recurrent symptoms.
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