What Valsalva maneuver is, what it is for and how to do it

The Valsalva maneuver is a technique in which you hold your breath, holding your nose with your fingers, and then you need to force the air out, applying pressure. This maneuver can be done easily, but people with pressure in the eyes and problems with the retina should not perform this type of test. In some cases, this maneuver may be requested during an examination of the heart, in order to assess heart failure or the presence of heart murmurs.

This maneuver is widely used in situations where the ear is plugged, as it facilitates the outflow of air through the ears, relieving the feeling of being clogged and can also be applied to help reverse heart problems, such as ventricular tachycardia, for example, as it helps in relaxation in the heart helping to regulate the heartbeat. Learn more about ventricular tachycardia and how to treat it.

What is it for

The Valsalva maneuver is a test performed using the pressure caused by holding the breath and forcing the air out and can be used in several situations, such as:

  • Assess the occurrence of heart failure;
  • Heart murmur identification;
  • Reverse cardiac arrhythmias;
  • Detect bleeding points after thyroid surgery;
  • Assist diagnosis of varicocele and hernias.

The technique used in this maneuver can help to unclog the ear in cases where there is a feeling of being clogged, during a flight, especially during takeoff or landing. To diagnose health problems, this maneuver should only be done in a laboratory, when carrying out an examination and under the supervision of a doctor.

How it should be done

To perform the Valsalva maneuver, one must first remain seated or lying down, breathing deeply and then it is necessary to close your mouth, pinch your nose with your fingers and force the air out, not letting it escape. At the end of the test, it is necessary to maintain the pressure for 10 to 15 seconds.

The technique used to perform this maneuver is similar to day-to-day situations, such as forcing to evacuate or playing a wind instrument, such as a saxophone.

Phases of the Valsalva maneuver

The Valsalva maneuver helps to reverse heart problems, such as arrhythmias, and some heart murmurs can be heard better, because during the technique, changes occur in the body that are divided into four phases:

  • Phase I: the beginning of the pressure caused by the act of holding the breath causes a transient increase in blood pressure, because at this moment there is an emptying of blood from the large veins, reducing the circulation of blood in the lungs;
  • Phase II: the pressure inside the chest causes the blood return to the heart to decrease, keeping the blood pressure falling, but with an increase in heart rate;
  • Phase III: it is the moment when the maneuver is being finalized, with a relaxation of the chest muscles and the blood pressure drops a little more;
  • Phase IV: in this phase the blood normally returns to the heart, regulating blood flow and blood pressure rises slightly.

These phases occur quickly and are not easily observed when performing the maneuver, but the effects of the test can be felt, especially if the person has a tendency to have hypotension, which are peaks of low pressure. See what to do when the pressure is low.

What are the risks

The Valsalva maneuver is not indicated for people who have problems with the retina, which is the layer that lines the eye, nor for people who have ocular lens implants, high intraocular pressure or congenital heart disease, as changes in blood pressure during performing the maneuver may worsen the picture of these conditions.

In addition, performing the Valsalva maneuver can cause chest pain, unbalance the heartbeat and cause episodes of vasovagal syncope, characterized by sudden loss of consciousness and fainting. Check out more what vasovagal syncope is and how to treat it.