The Effect of the Valsalva Maneuver on the Circulation

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Abstract
The normal response following sustained straining, as in a Valsalva maneuver, is a rise in systemic arterial pressure and a reflex slowing of the heart rate. This response was found to be abolished in some patients with mitral stenosis, with organic heart disease, with pulmonary vascular disease (including kyphoscoliosis), or with congenital heart disease. It was abolished in all three instances of pericardial disease studied. The relationship of the presence or absence of a poststraining bradycardia to cardiovascular dynamics at rest and on exercise as determined by right heart catheterization is presented, and the suggestion is made that the Valsalva maneuver, when performed under electrocardiographic control, may be a simple, dynamic stress test of the circulation. This suggestion is waiting for further exploration.