and vasodilators should be used with caution. An abrupt decrease in preload
may lead to inadequate cardiac output, which can result in the seizurelike symptoms seen inWill’s case. Anything that impairs venous return to the heart, such as vagal maneuver, should be avoided because the patient will exhibit profound signs of decreased cardiac output such as hypotension or
decreased level of consciousness. Stool softeners and laxatives may be necessary to avoid vagal maneuver.