The Valsalva maneuver was originally used to assess the condition of the middle ear, but it was also used to diagnose disorders of the nervous system, heart, and even varicocele. For what other purposes is the Valsalva maneuver performed? What is it?

The Valsalva maneuver(Valsalva maneuver) was originally used to clear the Eustachian tube and to equalize the pressure in the tympanic cavity with that of the surrounding air.

However, the Valsalva maneuver is now widely used in medicine, incl. in cardiology, in research on the autonomic system, as well as in aviation medicine or during diving (it is used by divers and airline passengers to equalize pressure in the middle ear).

Valsalva maneuver and patency of the Eustachian tube

Thanks to the Valsalva maneuver, the patency of the Eustachian tube can be assessed. The patient blows air from the lungs into the nose with his mouth closed and the wings of the nose pinched. The murmur of air that passes through the Eustachian tube is listened to with a special instrument - the so-called listener - by a doctor who assesses whether they are correct.

Valsalva maneuver in cardiology

The Valsalva maneuver in cardiology is a forceful exhalation (after having previously made maximum inhale) with the glottis closed, after previously inhaling deeply.

You can also blow out forcefully (after having fully inhaled previously) through the mouthpiece connected to a pressure gauge and maintain a pressure of 40 mmHg (without exceeding 50 mmHg) for 10-30 seconds (at least 7 seconds).

The maneuver increases chest pressure and reduces cardiac output. Doctors assess the work of the cardiovascular system - heart rate and blood pressure.

The Valsalva maneuver is helpful in the differentiation of intracardiac murmurs from, among others :

  • tricuspid regurgitation
  • mitral valve regurgitation
  • aortic stenosis
  • pulmonary stanoosis
  • hypertrophic cardiomyopathy

It is also used in patients with congestive heart failure and ischemic heart disease.

Valsalva maneuver in neuroscience

The Valsalva maneuver can also be used to detect functional disordersof the autonomic nervous system and the assessment of their advancement, e.g. in the diagnosis and monitoring of the progress of diabetic autonomic neuropathy as well as postalcoholic autonomic neuropathy.

It is also useful in diseases of the central nervous system with involvement of the autonomic centers (the autonomic nervous system is the part of the nervous system that controls and influences the functions of internal organs, including smooth muscles, heart muscle and glands - lacrimal, salivary, sweat) .

These will include diseases such as Parkinson's disease or multiple systemic atrophy.

Valsalva's attempt and varicose veins

The Abdominal Valsalva maneuver involves tensing your abdominal muscles, just like you are coughing. The pressure in the abdominal cavity increases rapidly, which allows the diagnosis of various ailments, such as varicocele.

There is also an involuntary reflex contraction of the external anal sphincter, on the basis of which it is possible to confirm stress incontinence (when coughing) and to evaluate the rectal-anal inhibition reflex.

Valsalva maneuver after tooth extraction

The Valsalva maneuver can also be performed after extraction (extraction) of the maxillary tooth. Thanks to this, the doctor can check whether the maxillary sinus has opened.

If this is the case, you hear a characteristic whistling sound or form bubbles of blood in the socket. However, it is currently not recommended due to the risk of developing a pneumothorax.

Category:

Research