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Background material by Professor Omar Hasan Kasule Sr. for Year 3 Semester 2 Med PPSD session on 09th February 2009
VASCULAR DISORDERS
Orthostatic hypotension is avoided by shortening the recitation to avoid standing for a long time, prolonged sitting between prostrations, frequent periods of rest and sitting down during rites of hajj like tawaaf.
Syncope necessitates delay of salat, hajj rites, and judicial proceedings.
Caution must be taken because physical exertion in salat, hajj and coitus may trigger a coronary attack or rupture of an aneurysm.
Patients with intermittent claudification, varicose veins, phlebitis, and thrombophlebitis should make tayammum and avoid very water for wudhu and must be cautious in salat movements or sitting down for tashahhud.
In DVT, movements of the lower limb in salat and hajj are limited for fear or dislodging an embolus. Prior prolonged sitting predisposes to embolus formation.
DISEASES OF THE HEART
In cases of mitral stenosis, mitral incompetence, and restrictive pericarditis, physical exertion in salat and hajj can lead to more severe decompensation.
CIRCULATORY DISORDERS
Patients in CCF may be too weak to pray. Standing up for prolonged periods in salat may worsen the lower leg edema and compromise venous return even further. The muscle movements of salat may however have a beneficial effect in venous return.
Fasting in CCF is not recommended. Hajj is better postponed in CCF because the patient may not be able to withstand the extra physical exertion involved.
In states of shock the physical movements of salat and hajj are not possible and Fasting is not allowed because of the need to replace body fluids.