Valsalva maneuver Guide, Meaning , Facts, Information and Description
A Valsalva maneuver is a forced expiration against the nose and mouth held closed. Also known as Valsalva's test and Valsalva's method, it is named after Antonio Maria Valsalva, a famous Italian anatomist. Valsalva's initial intention for the maneuver was as a method of expressing pus from the middle ear.Most people do Valsalva maneuvers inadvertently when blowing up balloons.
The Valsalva maneuver is used as a pressure equalisation technique by scuba divers and aeroplane passengers to avoid barotrauma and discomfort inside their ears when they move to or from a higher pressure breathing environment.
A person using this pressure equalisation technique pinches their nose, closes their mouth and tries to exhale. The technique works by raising the pressure in the throat so that a small volume of air moves from the throat to the ears through the Eustachian tube, which connects the two.
Medical uses of the Valsalva maneuver
A Valsalva maneuver increases vagal tone (parasympathetic) transiently. It can be used to try to correct the heart rhythm of someone in a supraventricular tachycardia, due to the effect of the increased vagal tone on the AV node of the heart.
Doing a Valsalva maneuver causes a transient lowering in ventricular filling and thus reduces the intensity of most cardiac murmurs. There are two exceptions to this rule, these being the murmur of hypertrophic cardiomyopathy and the murmur of mitral valve prolapse, which paradoxically become louder during a Valsalva maneuver.
There are four phases of a Valsalva maneuver. Phase I is identified as the onset of expiration against the closed glotis. This is associated with a transient increase in the arterial pressure and decrease in the heart rate. This is followed by phase II, which is due to continued expiration against the closed glottis. There is a gradual decreased in the blood pressure during this phase, and the heart rate overshoots and goes above the baseline heart rate. Phase III is the end of expiration, in which the blood pressure decreased further. This is followed by phase IV, in which the blood pressure overshoots and goes above the baseline blood pressure.
Some cardiologists measure the Valsalva ratio, which is the maximum heart rate in phase II over the minimum heart rate in phase IV of the Valsalva Maneuver.
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