Role of Valsalva maneuver in cardiology

Role of Valsalva maneuver in cardiology The initial description of Valsalva maneuver was published by Antonio Maria Valsalva in 1704. It was forced expiratory effort against the closed glottis, nose and mouth, lasting for a few seconds. The maneuver was employed with the aim of expelling foreign bodies or exudates from the middle ear [1]. Even today otolaryngologists use variations of the maneuver very often. Edward Weber in 1851 detailed the cardiovascular changes associated with maneuver, making it useful for diagnostic purpose. Hence some authors prefer to call it as Valsalva-Weber maneuver [2]. The classical four phases of Valsalva maneuver and its hemodynamic effects were described by Hamilton WF et al in 1936. In 1947 Rushmer made the assessment objective by expiratory straining against the mercury column of a sphygmomanometer. Later this was changed to an aneroid manometer for better convenience [1]. The subject is asked to take a full inspiration and blow against the resistance of a mouth piece connected to an aneroid manometer to maintain a pressure of 30 – 40 mm Hg for 15 – 20 seconds. It is then released and normal respiration resumed without gasping. Venous return decreases during the strain phase and reduces blood pressure which triggers baroreceptor mediated increase in heart rate. After cessation of straining, there is abrupt reversal resulting in overshoot of arterial pressure, which is known as Valsalva overshoot. This leads to baroreceptor media...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Source Type: blogs