II. Technique
- Standard Valsalva Maneuver
- Forceful expiration against a closed mouth and nose
- Postural modification significantly increases efficacy in PSVT cardioversion
- Valsalva is initially performed with head of bed at 30-45 degrees
- In study, Patient blew into a manometer attempting to sustain 40 mmHg for 15 seconds
- Patient repositioned immediately after Valsalva Maneuver
- Patient is layed supine and legs are passively raised
- References
- Valsalva is initially performed with head of bed at 30-45 degrees
- Reverse Valsalva Maneuver
- Patient is seated
- Exhales fully in regular fashion
- Pinches their nose, closes their mouth and inhales for 10 seconds
- Patient then resumes normal breathing after 10 seconds (opening mouth and removing hand from nose)
III. Physiology
- Increases intrathoracic pressure
- Briefly (<3-5 seconds) results in mildly increased Cardiac Output
- Decreases venous return
- After first 3-5 seconds, results in fall in Cardiac Output, and typically drop in Blood Pressure
IV. Indications
- Pressure equalization of nose and sinuses
- Examples: Drop in altitude in plane flight or increased external pressure in diving
- Other maneuvers are preferred (Yawning, Swallowing)
- Evaluate Tympanic Membrane mobility
-
Supraventricular Tachycardia
- Functions as a Vagal Maneuver
- See Techniques above (esp. Postural modification, Reverse Valsalva
- When Valsalva Maneuvers are effective in breaking SVT, they typically work within 15 seconds of maneuver
- Evaluate cardiac murmur
- Increases murmur or abnormal heart sounds
- Decreases murmur
V. References
- Bates (1991) Physical Exam, 5th ed, Lippencott, p. 302
- Warrington (2024) Crit Dec Emerg Med 38(11): 17
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Related Studies
| Definition (MSHCZE) | Usilovný výdech při zavřené hlasové štěrbině. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ ) |
| Definition (MSH) | Forced expiratory effort against a closed GLOTTIS. |
| Concepts | Diagnostic Procedure (T060) |
| MSH | D014636 |
| SnomedCT | 261039008, 79837007 |
| English | Maneuver, Valsalva's, Valsalva's maneuver, Valsalva maneuver (treatment), valsalva maneuver, valsalva manoeuvre, maneuver valsalva, manoeuvre valsalva, valsalva's maneuver, maneuvre valsalva, valsalva maneuvers, Valsalva Maneuver, Valsalva's Maneuver, Maneuver, Valsalva, Maneuvers, Valsalva, Valsalva Maneuvers, Valsalva maneuver, Valsalva manoeuvre, Valsalva maneuver (qualifier value), Valsalva maneuvre |
| Swedish | Valsalvas manöver |
| Czech | Valsalvův manévr, Valsavův manévr |
| Finnish | Valsalvan koe |
| Russian | VAL'SAL'VY PROBA, VAL'SAL'VY OPYT, ВАЛЬСАЛЬВЫ ОПЫТ, ВАЛЬСАЛЬВЫ ПРОБА |
| Japanese | Valsalva操作, ﾊﾞﾙｻﾙﾊﾞﾎｳ, バルサルバ法, Valsalvaテスト, バルサルバテスト, バルサルバ操作, バルサルバ試験, ワルサルワ操作, ヴァルサルヴァテスト, ヴァルサルヴァ操作, ヴァルサルヴァ試験 |
| German | Valsalva-Maneuver, Valsalva-Versuch |
| Dutch | valsalva-manoeuvre, Valsalva-manoeuvre, Manoevre, Valsalva- |
| Polish | Próba Valsalvy |
| Hungarian | Valsalva műveletsor |
| Norwegian | Valsalvas prøve, Valsalvas manøver |
| French | Manoeuvre de Valsalva, Manoeuvre de Vasalva |
| Spanish | maniobra de Valsalva (calificador), maniobra de Valsalva, Maniobra de Valsalva |
| Italian | Manovra di Valsalva |
| Portuguese | Manobra de Valsalva |
