Valsalva maneuver: How to do it, uses, and warnings

The Valsalva maneuver is a breathing technique that increases pressure in the chest. Doctors can use it to normalize some abnormally fast ... WhatistheValsalvamaneuver?MedicallyreviewedbyNancyHammond,M.D.—WrittenbyRachelNall,MSN,CRNAonAugust2,2018HowtodotheValsalvamaneuverUsesRisksandconsiderationsTakeawayTheValsalvamaneuverisaparticularwayofbreathingthatincreasespressureinthechest.Itcausesvariouseffectsinthebody,includingchangesintheheartrateandbloodpressure.Peoplemayperformthemaneuverregularlywithoutknowingit.Forexample,theymayuseitwhentheypushtoinitiateabowelmovement.However,thistechniquecanalsobebeneficialwhenpeopleuseitintentionallyasitcanregulateheartrhythmsandhelptheearstopop.ThephysicianAntonioMariaValsalvafirstdescribedthetechniqueinthe1700sasawaytoclearpusoutoftheears.HowtodotheValsalvamaneuverShareonPinterestTheValsalvamaneuverinvolvesholdingthebreath.TodotheValsalvamaneuver,followthesesteps:Inhaledeeplyandthenholdyourbreath.Imaginethatthechestandstomachmusclesareverytightandbeardownasthoughstrainingtoinitiateabowelmovement.Holdthispositionforashorttime,usuallyabout10seconds.Breatheoutforciblytoreleasethebreathrapidly.Resumenormalbreathing.Analternativemethodinvolveslyingdownandblowingintoanemptysyringefor15seconds.TheValsalvamaneuvercreatesnumerouseffectsinthebodybecauseitbuildsupthepressureinthepleuralcavity,knownastheintrapleuralpressure.Thisincreasedpressurecanleadtothecompressionofthechambersoftheheartandkeybloodvesselsinthebody,including:theaorta,whichisthemajorarterythatpumpsoxygen-richbloodthroughthebodythevenacava,whichisthemajorveinthatreturnsbloodtotheheartThecompressionoftheaortainitiallycausesthebloodpressuretorise.Asensorinthecarotidartery,calledthebaroreceptor,detectstheincreasedbloodpressure.Thisactivatesparasympatheticfibers,whichquicklyreducetheheartrateandbloodpressure.Doctorssometimesrefertothiseffectasvagaling.TheValsalvamaneuverreducescardiacoutput,whichistheamountofbloodthattheheartputsoutwitheverybeat.Theindividualmayfeellightheadedordizzyasaresult.Oncethebaroreceptorsensesthedecreaseinheartrateandbloodpressure,itwillstimulatethesympatheticnervoussystem.Thiscancauseaperson’sheartrateandbloodpressuretoincrease,offsettingtheparasympatheticeffects.However,whenapersonbreathesout,thisreleasesthecompressionontheheart,allowingittofillbackupwithblood.Breathingoutincreasesthepressureinsidetheaorta,stimulatingtheparasympatheticnervoussystemanddecreasingtheheartrateagain.UsesShareonPinterestTheValsalvamaneuverhelpstreatarapidheartrate.DoctorscanusetheValsalvamaneuvertotreatpeoplewithsupraventriculartachycardia(SVT).SVTisarapidheartratethatistypicallyover100beatsperminuteatrest.Itcancausesymptomsincludingheartpalpitations,chestpain,andshortnessofbreath.Aheartrateofthisspeedcanbedangerousbecausetheheartcannotpumpenoughbloodwhenitbeatssoquickly.SVToftenrequiresemergencytreatment.Onceemergencyrespondershaveidentifiedaperson’sheartrhythmanddeterminedthattheirbloodpressureisstable,theymaydemonstratehowtoperformtheValsalvamaneuver.AccordingtoareportintheJournaloftheAmericanCollegeofCardiology,theValsalvamaneuverwasmoreeffectiveinslowingdowntheheartratethanothersimilarprocedures,suchascarotidsinusmassageorapplyinganice-coldtoweltotheface.Ameta-analysisfoundthattheValsalvamaneuvercanrestoreregularheartratebetween19.4and54.3percentofthetime.IftheValsalvamaneuverdoesnotnormalizetheheartrhythm,apersonwillneedtoreceiveelectricshocks,calledcardioversion,ormedications.Theseapproachescancauseunpleasantsideeffects,suchaschestpain,pressure,andflushing.TheValsalvamaneuverhasotherusestoo.Theseinclude:clearingtheearswhenscubadivingorachangeinaltitudeincreasespressureincreasingcolonicpressuretoinduceabowelmovementWeightliftersalsotendtoperformtheValsalvamaneuverwhentheyliftheavyweights.Somemaytrythistechniquedeliberatelywhileotherswillnotrealizethattheyareusingit.ItisacommonbeliefthatusingtheValsalvamaneuverwhenliftingheavyweightscanprovidemomentumandtrunkstabilization.RisksandconsiderationsTheprimarysideeffectoftheValsalvamaneuverishypotension,whichisasudden,persistentdecreaseinbloodpressure.Peopleperformingthemaneuvermayalsofeellightheadedorexperiencesyncope,whichisabrieflossofconsciousness.TakeawayTheValsalvamaneuvercanhelpreducerapidheartrhythmsforsomepeople.Itcanalsohelppeopletopoptheirears,liftweights,orhaveabowelmovement.WhiletheValsalvamaneuverdoeshavesomepotentialsideeffects,itisanon-invasivealternativetoothertreatments,suchasmedicationorelectricshocks.LastmedicallyreviewedonAugust2,2018RespiratoryCardiovascular/CardiologyEar,Nose,andThroatRehabilitation/PhysicalTherapy6sourcescollapsedMedicalNewsTodayhasstrictsourcingguidelinesanddrawsonlyfrompeer-reviewedstudies,academicresearchinstitutions,andmedicaljournalsandassociations.Weavoidusingtertiaryreferences.Welinkprimarysources—includingstudies,scientificreferences,andstatistics—withineacharticleandalsolistthemintheresourcessectionatthebottomofourarticles.Youcanlearnmoreabouthowweensureourcontentisaccurateandcurrentbyreadingoureditorialpolicy.Ekinci,S.,Akgül,G.,Arş,E.,Aydin,A.,Musalar,E.,&Aktaş,C.(2017,November10).Valsalvamaneuver techniquesforsupraventriculartachycardias:Whichandhow?HongKongJournalofEmergencyMedicine,24(6),298–302http://journals.sagepub.com/doi/full/10.1177/1024907917740092Hackett,D.A.,&Chow,C.-M.(2013,August).TheValsalvamaneuver:Itseffectonintra-abdominalpressureandsafetyissuesduringresistanceexercise.JournalofStrengthandConditioningResearch,27(8),2338–2345https://journals.lww.com/nsca-jscr/Fulltext/2013/08000/The_Valsalva_Maneuver___Its_Effect_on.39.aspxKlabunde,R.E.(2014,April28).HemodynamicsofaValsalvamaneuverhttps://www.cvphysiology.com/Hemodynamics/H014Page,R.L.,Joglar,J.A.,Caldwell,M.A.,Calkins,H.,Conti,J.B.,Deal,B.J.,…Al-Khatib,S.M.(2016,April).2015ACC/AHA/HRSguidelineforthemanagementofadultpatientswithsupraventriculartachycardia.JournaloftheAmericanCollegeofCardiology,67(13)http://www.onlinejacc.org/content/67/13/e27?_ga=1.87330320.984974867.1480494374Smith,G.D.,Fry,M.M.,Taylor,D.,Morgans,A.,&Cantwell,K.(2015,February18).TheeffectivenessoftheValsalvamanoeuvreforstoppinganabnormalheartrhythm.CochraneDatabaseofSystematicReviews,2015(2)https://www.cochrane.org/CD009502/VASC_the-effectiveness-of-the-valsalva-manoeuvre-for-stopping-an-abnormal-heart-rhythmValsalva maneuver.(n.d.)https://ww2.mc.vanderbilt.edu/adc&doc=4791/38918FEEDBACK:MedicallyreviewedbyNancyHammond,M.D.—WrittenbyRachelNall,MSN,CRNAonAugust2,2018LatestnewsMolnupiravirvs.COVID-19:Hasitliveduptotheearlyhype?NervedamageinlongCOVIDmayarisefromimmunedysfunction'Notamiracledrug':ExpertsonIvermectininCOVID-19treatmentStudyfindsfitnessmayreducedementiariskby33%StudyfindssignificantdisparitiesincancerratesamongracialgroupsRelatedCoverageWhatisanormalbloodpressure?MedicallyreviewedbyUniversityofIllinoisBloodpressureisessentialtolifebecauseitforcesthebloodaroundthebody,deliveringallthenutrientsitneeds.Here,weexplainhowtotake…READMOREEighthomeremediesforuncloggingyourearsMedicallyreviewedbyNancyChoi,MDCloggedearscancausediscomfort,andmayaffecthearingandbalance.Learnabouteightdifferenthomeremediestotreatcloggedears,andwhatto…READMOREWhat'stoknowabouttheEpleymaneuver?MedicallyreviewedbyAlanaBiggers,M.D.,MPHVertigocanbeadisorientinganddebilitatingcondition.However,therearesolutionsforrelievingsymptomsanddizzyepisodes.TheEpleymaneuver…READMORE15naturalwaystoloweryourbloodpressureMedicallyreviewedbyAtliArnarsonPh.D.Highbloodpressureiscommon,affectingoneinthreepeopleintheU.S.Wediscussnaturalwaystoreducebloodpressure,includingdiet,exercise…READMORE