Presentation
We reproduced, in part, the hemodynamic and biochemical manifestations of this presentation with Valsalva maneuver in healthy subjects. [ncbi.nlm.nih.gov]
Entire Body System
- Atrial Septal Defect
The Valsalva maneuver could cause an atrial septal swing, and its sensitivity and specificity were 100%. [ncbi.nlm.nih.gov]
Abnormal hemodynamic response to Valsalva maneuver in patients with atrial septal defect evaluated by Doppler echocardiography [33]. [wikigenes.org]
[CrossRef] [PubMed] Hancock, E., Oliver, G., Swanson, M., and Huligren, H., 1963, “ Valsalva's Maneuver in Atrial Septal Defect,” Am. Heart J., 65(1), pp. 50–58. [biomechanical.asmedigitalcollection.asme.org]
Guidelines for the echocardiographic assessment of atrial septal defect and patent foramen ovale: from the American Society of Echocardiography and Society for Cardiac Angiography and Interventions. [link.springer.com]
At the same time, the Valsalva maneuver (phase II) decreases the intensity of most other murmurs, including aortic stenosis and atrial septal defect. [en.wikipedia.org]
- Collapse
Collapsed IVC showed during the maneuver in normal healthy subjects using ultrasonography study, but IVC showed angular appearance and not collapsed during the maneuver in the venography study [ 10, 11 ]. [e-ultrasonography.org]
The scope should be gradually withdrawn through the bladder neck and urethra, taking care to view the urethral mucosa and structure as the lumen collapses past the end of the scope. [emedicine.medscape.com]
There is a substantial increase in the vascular lumen, especially in those patients in whom the vessel is found to be collapsed (e.g. in hypovolemic patients). [neurologyindia.com]
Collapse all Expand all Antecedentes Los pacientes con arritmia cardíaca por taquicardia supraventricular (TSV) acuden a los médicos con frecuencia en ámbitos de medicina prehospitalarios y de urgencia. [cochranelibrary.com]
- Inflammation
Intra-articular injection of steroid is a common treatment for osteoarthritis of the knee and injection is a simple and reliable method of for relieving pain and inflammation in patients with knee osteoarthritis. [medcraveonline.com]
Consider a nasal steroid spray, such as Flonase to limit inflammation of the sinus lining. Surgical Procedure Debride the socket and pack with Gelfoam to help form a blood clot. [oasisdiscussions.ca]
Bladder neck fronds and polyps or cystitis cystica can indicate prior or chronic inflammation. Findings including urinary tract fistulas, diverticular openings, and functional ureteral abnormalities can be also visualized with cystourethroscopy. [emedicine.medscape.com]
- Surgical Procedure
METHODS: A prospective observational study included 100 women with POP attending a tertiary urogynecology clinic in the UK and undergoing vaginal prolapse surgical procedures between October 2011 and October 2014. [ncbi.nlm.nih.gov]
Surgical Procedure Debride the socket and pack with Gelfoam to help form a blood clot. Close with a buccal advancement flap: advance some buccal soft tissue over onto the palate and secure it with sutures. [oasisdiscussions.ca]
Fenestration surgery for otosclerosis: CT findings of an old surgical procedure. AJNR Am J Neuroradiol 21: 1670-1672, 2000. Ostrowski VB, Byskosh A, and Hain TC. Tullio phenomenon with dehiscence of the superior semicircular canal. [dizziness-and-balance.com]
- Infectious Mononucleosis
Bilateral cervical adenopathy is also prominent in tuberculosis, coccidioidomycosis, infectious mononucleosis, toxoplasmosis, sarcoid, lymphomas, and leukemias. [ncbi.nlm.nih.gov]
Respiratoric
- Sneezing
Next, various nasal irritants were used to induce a sneeze. [ncbi.nlm.nih.gov]
As a matter of fact, it’s something that could potentially occur any time you have a bodily function… …For example, you will involuntarily perform the Valsalva maneuver if you strain while sneezing, coughing, gagging, tossing your cookies, taking a leak [kingofthegym.com]
There was no history of trauma or violent exertion but the patient had hay fever and had frequent episodes of sneezing. On examination his vision was 6/6 and hand movements in right and left eyes, respectively. [doi.org]
Common Initial Treatment: Estimate the fistula diameter 1-2 mm : No treatment required as it will usually naturally heal. 2 -4 mm : Carefully follow the patient after 1-2 weeks and advise to avoid straining the area (no holding back sneezes, no smoking [oasisdiscussions.ca]
- Dyspnea
BACKGROUND: For the clinical assessment of patients with dyspnea, the inversion of the early (E) and late (A) transmitral flow during Valsalva maneuver (VM) frequently helps to distinguish pseudonormal from normal filling pattern. [ncbi.nlm.nih.gov]
University Medical Center Acceleration Techniques and Speed Development BrianMac Sports Coach Labriola LT et al, 2009, Marathon’s runner retinopathy PubMed Marantz PR et al, 1990, Clinical diagnosis of congestive heart failure in patients with acute dyspnea [ehealthstar.com]
Gastrointestinal
- Vomiting
Soon after intravenous injection of fluorescein, the patient had an extended episode of vomiting resulting in bilateral vitreous hemorrhages. [ncbi.nlm.nih.gov]
"a particular form of retinopathy, pre-retinal and hemorrhagic in nature, secondary to a sudden increase in intrathoracic pressure." [1] It was used to describe retinal hemorrhages in association with heavy lifting, coughing, straining at stool, or vomiting [emedicine.com]
Defecation or urination (many dies on the toilet seat), using the arm and upper trunk muscles to move up in bed, or strains during coughing, gagging or vomiting. [breathing.com]
- Constipation
In individuals with both severe coronary heart disease and constipation, but unlikely in healthy individuals, straining at the toilet may trigger a heart attack. [ehealthstar.com]
Constipation is a very common human experience and should be regarded as an important precipitating factor in some migraine patients, particularly those who are found refractory to routine preventive strategies. [jewisoneqynyje.ml]
Constipation increases the risk of cardiovascular trauma in such patients, especially if they perform a Valsalva maneuver in trying to move their bowels. [medical-dictionary.thefreedictionary.com]
Cardiovascular
- Tachycardia
Patients were at least 10 years of age with regular narrow complex tachycardia and had an ECG diagnosis of SVT. Patients with regular narrow complex tachycardia were randomly assigned to undergo either the Valsalva maneuver or CSM. [ncbi.nlm.nih.gov]
There is a regular narrow complex tachycardia at a rate of 191. There are no visible P-waves. This is likely AV nodal reentrant tachycardia (AVNRT) or orthodromic AV reentrant tachycardia (AVRT). [ecgmedicaltraining.com]
- Heart Disease
Responses (4) and (5) disappear with many forms of heart disease. [med.umich.edu]
Of these, 14 showed clinical signs of congestive heart failure and 11 had significant heart disease. [jamanetwork.com]
- Palpitations
If this procedure does not stop your SVT and the palpitations continue for more than 20 minutes, you may need to go to the emergency department for treatment. [fairview.org]
For example, your next door neighbor comes to you complaining of palpitations or what may be SVT and you advise them to sit on the toilet or in a chair and exert force as if they were having a bowel movement. [allnurses.com]
Case: A 19-year-old male arrives at the ED complaining of palpitations. He is known to have supraventricular tachycardia (SVT) and has been in before for the same condition. He is hemodynamically stable, and the electrocardiogram (ECG) shows SVT. [acepnow.com]
EMS is called to the clubhouse of a golf course for a female patient in her early 50s complaining of palpitations. She had just finished playing 18 holes when her “heart started racing”. [ecgmedicaltraining.com]
Symptoms may include awareness of tachycardia, palpitation, dizziness, breathlessness, mild chest discomfort and syncope, although some patients remain asymptomatic. [racgp.org.au]
- Chest Pain
On rare occasions, the Valsalva maneuver can be used to diminish chest pain in patients with mild coronary disease. [encyclopedia.com]
People who suffer from the sudden, sharp chest pains called angina pectoris usually carry nitroglycerin pills or amyl nitrite for quick, dramatic relief. [content.time.com]
Return to the emergency department if: You have sudden, severe chest pain or trouble breathing. © Copyright IBM Corporation 2018 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. [drugs.com]
She denies chest pain but admits to feeling breathless. Breath sounds are clear and equal bilaterally. Vital signs are assessed. RR: 18 HR: 200 NIBP: 138/100 Temp: 98.9 F / 37.2 C SpO2: 97% on room air The cardiac monitor is attached. [ecgmedicaltraining.com]
Eyes
- Scotoma
History Sudden, painless visual loss or scotoma after a Valsalva’s maneuver. It is usually unilateral, although may rarely be bilateral. [eyewiki.aao.org]
Neurologic
- Amnesia
Kessler J, Markowitsch HJ, Rudolf J, Heiss WD (2001) Continuing cognitive impairment after isolated transient global amnesia. Int J Neurosci 106:159–168 PubMed CrossRef Google Scholar 10. Lewis SL (1998) Aetiology of transient global amnesia. [doi.org]
The association of valvular insufficiency and longer reflux times with the occurrence of a trigger event further suggests that cerebral venous congestion is an important etiological factor in transient global amnesia. [ncbi.nlm.nih.gov]
Weightlifting Dangers Complications of repeated Valsalva maneuvers during weightlifting: Fainting [50] Transient global amnesia: temporary ( [28] Spontaneous cerebrospinal fluid (CFS) leak (clear liquid dropping out from one nostril) [26] Brain bleeding [ehealthstar.com]
- Forgetful
Also, don’t forget to like and share this with your colleagues either! Until next time, stay safe during the last minute Christmas rush! [ditchdocem.com]
You get under the bar and pop it out, except you forget one crucial part as you descend. You forgot to take a big belly of air and you fail the lift as the bar crashes into the safeties. If you’re not angry reading that, you’re doing it wrong. [liftbigeatbig.com]
- Perseveration
However, I believe that, with perseverance, you will do it! About Brad Brad Howland is the Principal Trombonist of the Victoria Symphony Orchestra. This is hidden text to fill the width of the container. [musicforbrass.com]
Treatment
Safety and efficacy of paramedic treatment of regular supraventricular tachycardia. Heart. 2013;99(suppl 2):A46.1-A46. Further Reading Treating Supraventricular Tachycardia With Adenosine [ecgmedicaltraining.com]
If this procedure does not stop your SVT and the palpitations continue for more than 20 minutes, you may need to go to the emergency department for treatment. [fairview.org]
The Valsalva maneuver is used in clinical medicine for the diagnosis and/or treatment of various cardiovascular conditions. It can also be used in activities of daily living, such as defecation. [ncbi.nlm.nih.gov]
Synchronized cardioversion is usually the treatment of choice in the hemodynamically unstable patient. [acepnow.com]
Postural Modification to the Standard Valsalva Manoeuvre for Emergency Treatment of Supraventricular Tachycardias (REVERT): A Randomised Controlled Trial. Lancet 2015. [rebelem.com]
Prognosis
Prognosis. Abstract Introduction and objectives. In patients with systolic dysfunction, different ventricular filling patterns are associated with different prognoses. [revespcardiol.org]
Myelopathy-related priapism potentiated by the Valsalva maneuver can be easily overlooked without heightened vigilance, leading to poor therapeutic response and prognosis. [ncbi.nlm.nih.gov]
Age Persons of any age can be affected. [7] Prognosis Prognosis is generally good, as complete recovery of vision (with observation) usually occurs within weeks to months following onset. [emedicine.com]
Complications associated with laser membranotomy include macular hole, retinal detachment, and epiretinal membrane formation. [7] [8] Prognosis Good prognosis with complete recovery to baseline vision after resolution occurring within weeks to months [eyewiki.aao.org]
Etiology
The association of valvular insufficiency and longer reflux times with the occurrence of a trigger event further suggests that cerebral venous congestion is an important etiological factor in transient global amnesia. [ncbi.nlm.nih.gov]
ORIGINAL COMMUNICATION First Online: 07 July 2005 Abstract Objective While transient global amnesia (TGA) is a clinically well defined disorder, its etiology is poorly understood. [doi.org]
Etiology It occurs after an increase in intrathoracic or intraabdominal pressure due to activities such as coughing, vomiting, lifting, straining for a bowel movement, strenuous exertion, sexual intercourse, labor, blowing musical instruments and compression [eyewiki.aao.org]
Ventricular dysfunction was due to an ischemic etiology in the majority of cases (26), 6 patients had dilated cardiomyopathy and 5 had other conditions (alcoholic or hypertensive heart disease). [revespcardiol.org]
Epidemiology
Baltimore, Maryland. 5 Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland. 6 Departments of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Biostatistics and Epidemiology [ncbi.nlm.nih.gov]
You see, like most things in the human body, the response to the Valsalva maneuver is nuanced and extraordinarily complex. ( Editor's note: while all the details behind the Valsalva’s physiology and related epidemiology is beyond the scope of this article [floelite.com]
Epidemiology Frequency The frequency of Valsalva retinopathy is difficult to ascertain considering the rare nature of the condition. United States The incidence of Valsalva retinopathy in the United States has not been reported. [emedicine.com]
Pathophysiology
The clinical relevance of this finding and the pathophysiologic implications are reviewed and discussed. [ncbi.nlm.nih.gov]
Pathophysiology A sudden rise in intrathoracic or intraabdominal pressure against a closed glottis, the Valsalva’s maneuver reduces venous return to the heart and stroke volume, consequently increasing venous system pressure. [eyewiki.aao.org]
Evidence in experimental animal and humans, pathophysiological mechanisms, and potential clinical consequences. Hypertension 28(3): 494-504. [medcraveonline.com]
Prevention
How to prevent pain in the ear when you are in the plane? | Mun Fitness Blog [lifehacker.com]
In management of air embolism, sealing the site of air entry is an important step in preventing further episodes. [ncbi.nlm.nih.gov]
The maneuver causes a trapping of blood in the great veins, preventing it from entering the chest and right atrium. [breathing.com]