Valsalva maneuver: Difference between revisions

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A breathing technique used to equalize pressure in the ears and chest

Valsalva maneuver

The Valsalva maneuver is a breathing technique that involves attempting to exhale with the nostrils and mouth, or the glottis, closed. This maneuver is named after Antonio Maria Valsalva, an Italian physician who first described it in the 17th century. It is commonly used to equalize pressure in the middle ear and sinuses, and is also employed in various medical tests and procedures.

Mechanism

The Valsalva maneuver involves a forced expiration against a closed airway. This is typically achieved by closing the mouth and pinching the nose shut while attempting to exhale forcefully. The maneuver increases pressure in the thoracic cavity, which can affect the cardiovascular system and autonomic nervous system.

The Valsalva maneuver can be used to equalize ear pressure.

Uses

The Valsalva maneuver is used in several contexts:

Equalizing ear pressure: It is commonly used by scuba divers, aviators, and individuals experiencing rapid altitude changes to equalize pressure in the middle ear.
Medical testing: The maneuver is used in cardiology to assess heart function and diagnose certain heart conditions. It can also be used to test the function of the autonomic nervous system.
Childbirth: The maneuver is sometimes used during the second stage of labor to assist with pushing.

Risks and contraindications

While generally safe, the Valsalva maneuver can have risks, particularly for individuals with certain medical conditions. It can lead to a temporary decrease in venous return to the heart, which may cause a drop in blood pressure and heart rate. People with cardiovascular disease or glaucoma should consult a healthcare professional before performing the maneuver.

History

The maneuver is named after Antonio Maria Valsalva, who described it in his 1704 publication on the anatomy of the human ear. Valsalva originally described the technique as a way to clear pus from the middle ear.

Related pages

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-The Valsalva maneuver is a common medical procedure often employed in both diagnostic and therapeutic settings. It's named after the 17th-century Italian anatomist Antonio Maria Valsalva, who first described its utility in the examination of the ear.
+{{Short description|A breathing technique used to equalize pressure in the ears and chest}}
+{{Use dmy dates|date=October 2023}}
+[[File:Samantha_Cristoforetti_demonstrating_Valsalva_device.jpg|thumb|right|[[Samantha Cristoforetti]] demonstrating a Valsalva device.]]
+== Valsalva maneuver ==
+The '''Valsalva maneuver''' is a breathing technique that involves attempting to exhale with the nostrils and mouth, or the glottis, closed. This maneuver is named after [[Antonio Maria Valsalva]], an Italian physician who first described it in the 17th century. It is commonly used to equalize pressure in the [[middle ear]] and [[sinuses]], and is also employed in various medical tests and procedures.
-== Description ==
+[[File:Valsalva_maneuver.jpg|thumb|right|A diagram illustrating the Valsalva maneuver.]]
-The Valsalva maneuver is performed by moderately forceful attempted exhalation against a closed airway, usually done by closing one's mouth, pinching one's nose shut while expelling air out as if blowing up a balloon.<ref>{{Cite journal|last1=Smith|first1=Richard|title=The Valsalva manoeuvre: a critical review|journal=Heart|date=2015|volume=101|issue=18|pages=1446–1451|doi=10.1136/heartjnl-2015-307541|pmid=26109559}}</ref>
-== Medical Uses ==
+== Mechanism ==
-=== Diagnostic ===
+The Valsalva maneuver involves a forced expiration against a closed airway. This is typically achieved by closing the mouth and pinching the nose shut while attempting to exhale forcefully. The maneuver increases pressure in the [[thoracic cavity]], which can affect the [[cardiovascular system]] and [[autonomic nervous system]].
-The maneuver can be used in a medical examination as a test of cardiac function and [[autonomic nervous system|autonomic nervous control]] of the heart.<ref>{{Cite journal|last1=Smith|first1=Richard|title=The Valsalva manoeuvre: a critical review|journal=Heart|date=2015|volume=101|issue=18|pages=1446–1451|doi=10.1136/heartjnl-2015-307541|pmid=26109559}}</ref> Variations of the maneuver can be used to diagnose conditions such as [[orthostatic hypotension]] and [[postural orthostatic tachycardia syndrome|POTS]].
-=== Therapeutic ===
+[[File:Valsalva3.jpg|thumb|right|The Valsalva maneuver can be used to equalize ear pressure.]]
-In addition to its diagnostic uses, the Valsalva maneuver can also be used therapeutically to clear the ears and sinuses (that is, to equalize pressure between them) when ambient pressure changes, such as in [[scuba diving]], [[hyperbaric oxygen therapy]], or [[air travel]].<ref>{{Cite journal|last1=Smith|first1=Richard|title=The Valsalva manoeuvre: a critical review|journal=Heart|date=2015|volume=101|issue=18|pages=1446–1451|doi=10.1136/heartjnl-2015-307541|pmid=26109559}}</ref> It can also be used to terminate [[supraventricular tachycardia]] (SVT), a rapid heart rhythm originating at or above the atrioventricular node.
-== Procedure ==
+== Uses ==
-During the Valsalva maneuver, individuals are typically asked to take a deep breath and then forcibly exhale against a closed airway. This can be achieved by closing the mouth and pinching the nose shut while "bearing down" or attempting to exhale. This causes various physiologic changes, including increased intrathoracic pressure, decreased venous return to the heart, and, ultimately, changes in heart rate and blood pressure.
+The Valsalva maneuver is used in several contexts:
-== Risks ==
+* '''Equalizing ear pressure''': It is commonly used by [[scuba divers]], [[aviators]], and individuals experiencing rapid altitude changes to equalize pressure in the middle ear.
-Despite its benefits, the Valsalva maneuver is not without risks. It can potentially lead to the development of [[barotrauma]], particularly in those with underlying lung disease. It should be used with caution in individuals with cardiovascular disease, as the changes in heart rate and blood pressure can potentially exacerbate these conditions.<ref>{{Cite journal|last1=Smith|first1=Richard|title=The Valsalva manoeuvre: a critical review|journal=Heart|date=2015|volume=101|issue=18|pages=1446–1451|doi=10.1136/heartjnl-2015-307541|pmid=26109559}}</ref>
+* '''Medical testing''': The maneuver is used in [[cardiology]] to assess heart function and diagnose certain heart conditions. It can also be used to test the function of the [[autonomic nervous system]].
+* '''Childbirth''': The maneuver is sometimes used during the [[second stage of labor]] to assist with pushing.
-== Physiology ==
+== Risks and contraindications ==
-The Valsalva maneuver consists of four distinct phases, each with its own physiological response.<ref>{{Cite journal|last1=Smith|first1=Richard|title=The Valsalva manoeuvre: a critical review|journal=Heart|date=2015|volume=101|issue=18|pages=1446–1451|doi=10.1136/heartjnl-2015-307541|pmid=26109559}}</ref>
+While generally safe, the Valsalva maneuver can have risks, particularly for individuals with certain medical conditions. It can lead to a temporary decrease in [[venous return]] to the heart, which may cause a drop in [[blood pressure]] and [[heart rate]]. People with [[cardiovascular disease]] or [[glaucoma]] should consult a healthcare professional before performing the maneuver.
-=== Phase One ===
+== History ==
-The onset of the maneuver where intrathoracic pressure increases, causing a brief rise in blood pressure due to compression of the aorta.
+The maneuver is named after [[Antonio Maria Valsalva]], who described it in his 1704 publication on the anatomy of the human ear. Valsalva originally described the technique as a way to clear pus from the middle ear.
-=== Phase Two ===
+== Related pages ==
-The pressure continues to build up within the thoracic cavity, leading to a decrease in venous return to the heart and subsequently a drop in cardiac output and blood pressure. The body compensates by increasing the heart rate and constricting peripheral blood vessels to maintain blood flow to vital organs.
+* [[Barotrauma]]
+* [[Autonomic nervous system]]
-=== Phase Three ===
+* [[Cardiovascular system]]
-This phase begins when the individual stops straining, leading to a sudden drop in intrathoracic pressure. This briefly leads to further decreased blood pressure.
-=== Phase Four ===
-The final phase is characterized by a rapid increase in cardiac output and blood pressure. This is due to the sudden increase in venous return to the heart following the release of intrathoracic pressure. The body responds by decreasing the heart rate to prevent a sudden surge in blood pressure.
-== See Also ==
+[[Category:Medical procedures]]
-* [[Barotrauma]]
+[[Category:Breathing techniques]]
-* [[Orthostatic hypotension]]
-* [[Postural orthostatic tachycardia syndrome|POTS]]
-* [[Hyperbaric oxygen therapy]]
-* [[Supraventricular tachycardia]]
-== References ==
-<references />
-{{stub}}
-[[Category:Medical maneuvers]]
-[[Category:Cardiology]]
-[[Category:Otorhinolaryngology]]
-[[Category:Respiratory physiology]]