The valsalva maneuver as a test of cardiac function

Abnormal Heart Rate Responses during Exercise in Patients with Chagas’ Disease

“…The Valsalva maneuver was used to evaluate the para sympathetic influences on the sinus node [41]. This test provides in formation regarding the sympathetic division of the autonomic nervous system [41] and the functional reserve of the heart [20,38]. In spite of the observations that sympathetic stimulation contributes to tachycardia of hypotension [16,17,19,31,40] there is no agreement concerning the extent of this mechanism [24,32], the relative contribution of the autonomic components apparently depending upon the balance of tone before the intervention [33,37].…”

“…It must be emphasized that none of the patients studied here had clinical or hemo dynamic evidence of grossly impaired myocardial function which is known to cause alterations in autonomic responses [9,17,20,38].…”

Effect of Valsalva Maneuver on Oxygen Saturation in Patients with Intracardiac Shunts

“…The initial dip in saturation is probably due to an increased inflow of the blood from the systemic veins associated with the deep inspiration22 that preceded the increase in airway pressure, whereas the rise in saturation during the period of increased intrathoracie pressure must be related to the decrease in systemic venous return well known to occur during the Valsalva maneuver. 19 20,[23][24][25] The increase in saturation could result if the volume of blood shunted from left to right increased, re-mained unchanged, or decreased but to a lesser degree than the decrease in systemic venous return. The decline in pulmonary artery saturation later during the period of increased intrathoracic pressure could result from an increase in systemic venous return, a decrease in the volume of the left-to-right shunt, or both.…”

Normal, Pharmacological and Disordered Systemic Circulatory Responses to the Valsalva Manoeuvre

“…I n te rm e d ia te responses h av e been o b serv ed in a v a rie ty o f c o n g e n ita l an d a c q u ire d h e a rt diseases [24] b u t th e precise e x te n t of th e ir differen ce from th e n o rm a l req u ires f u rth e r s tu d y . In o rd er L o e sta b lish if th e a b n o rm a l sy ste m ic a rte ria l blood pressu re p a tte rn m ight be clin ically useful an d q u a lita tiv e ly d istin g u ish a b le fro m th e n o rm al it seem ed im p o rta n t to su b je c t th e n o rm a l p erip h eral blood p ressu re re sp o n se to t he V alsalv a M anoeuvre to careful m e a su re m e n t, an d to c o m p a re th e se m e a su re m e n ts w ith those o b ta in e d from norm al in d iv id u a ls a fte r th e a d m in is tra tio n o f d ru g s w hich selectiv ely in fluence th e n o rm a l b a ro c e p to r m ech an ism s. I t is th e p u rp o se of th is p a p e r to p re s e n t th e re su lts of m e a su re m e n ts of th e n o rm a l a rte ria l blood p re ssu re p a tte rn d u rin g th e V alsalv a M a n o eu v re, an d to c o m p a re these m e a su re m e n ts w ith :…”

“…K nowles el al. 123] a n d Gorlin et al [24] fo u n d th a t th e so-called a b n o rm a l s q u a re w ave or su sta in e d a rte ria l p re ssu re resp o n se d u rin g a ir-w ay s tra in in g in left v e n tric u la r fa ilu re re v e rte d to n o rm al a fte r successful th e ra p y . T he a b n o rm a l b a ro c e p to r resp o n ses fo u n d d u rin g th e o v ersh o o t in p a tie n ts w ith s y m p a th e tic out-flow tra c t lesions a n d afferent p a th w a y d iso rd ers b ro a d e n e d th e clin ical in te re s t in th is te s t [6,25,20].…”