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Valsalva Maneuver

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81. Retinopathy, Valsalva (Diagnosis)

. The Valsalva maneuver was named after the Italian anatomist Antonio Maria Valsalva, who defined the Valsalva ligaments and anatomy related to the forcible exhalation effort against a closed glottis. Valsalva retinopathy classically manifests as preretinal hemorrhage secondary to rupturing of superficial retinal vessels caused by physical exertion. The mechanism of a Valsalva maneuver is characterized by a sudden rise in intrathoracic or intraabdominal pressure against a closed glottis, which leads (...) to a rapid rise of intravenous pressure within the eye, causing retinal capillaries to spontaneously rupture. Prognosis is usually good, with spontaneous resolution occurring within months after onset, but depends on location of the hemorrhage and the layer of retina involved. See the images below. Initial presentation of a Valsalva retinopathy less than 24 hours following a Valsalva maneuver in an 18-year-old man. Note the large preretinal hemorrhage. Vision was finger counting at 5 feet. At 4-month

2014 eMedicine.com

82. Retinopathy, Valsalva (Treatment)

: Diet Diet restrictions are not essential in the management of Valsalva retinopathy. A diet rich in fiber is advisable for those patients with constipation in order to prevent further Valsalva maneuvers that could possibly cause a rebleed. Previous Next: Activity To reduce the risk of a rebleed, physical activity should be limited immediately following the clinical diagnosis and until the retina has sufficiently healed. Individuals with known proliferative diabetic retinopathy (or other retinal (...) vascular diseases) are at increased risk for the development of a vitreous hemorrhage secondary to a Valsalva maneuver; therefore, they should always try to limit activities that cause sudden increases in intrathoracic pressure against a closed glottis. Patients should be advised to sleep in an upright sitting position to promote settling of the blood inferiorly out of the visual axis. Previous Next: Prevention Avoid Valsalva-like maneuvers, if possible. To prevent a rebleed, physical activity should

2014 eMedicine.com

83. Retinopathy, Valsalva (Overview)

. The Valsalva maneuver was named after the Italian anatomist Antonio Maria Valsalva, who defined the Valsalva ligaments and anatomy related to the forcible exhalation effort against a closed glottis. Valsalva retinopathy classically manifests as preretinal hemorrhage secondary to rupturing of superficial retinal vessels caused by physical exertion. The mechanism of a Valsalva maneuver is characterized by a sudden rise in intrathoracic or intraabdominal pressure against a closed glottis, which leads (...) to a rapid rise of intravenous pressure within the eye, causing retinal capillaries to spontaneously rupture. Prognosis is usually good, with spontaneous resolution occurring within months after onset, but depends on location of the hemorrhage and the layer of retina involved. See the images below. Initial presentation of a Valsalva retinopathy less than 24 hours following a Valsalva maneuver in an 18-year-old man. Note the large preretinal hemorrhage. Vision was finger counting at 5 feet. At 4-month

2014 eMedicine.com

84. Retinopathy, Valsalva (Follow-up)

: Diet Diet restrictions are not essential in the management of Valsalva retinopathy. A diet rich in fiber is advisable for those patients with constipation in order to prevent further Valsalva maneuvers that could possibly cause a rebleed. Previous Next: Activity To reduce the risk of a rebleed, physical activity should be limited immediately following the clinical diagnosis and until the retina has sufficiently healed. Individuals with known proliferative diabetic retinopathy (or other retinal (...) vascular diseases) are at increased risk for the development of a vitreous hemorrhage secondary to a Valsalva maneuver; therefore, they should always try to limit activities that cause sudden increases in intrathoracic pressure against a closed glottis. Patients should be advised to sleep in an upright sitting position to promote settling of the blood inferiorly out of the visual axis. Previous Next: Prevention Avoid Valsalva-like maneuvers, if possible. To prevent a rebleed, physical activity should

2014 eMedicine.com

85. Valsalva Manœuvre in the Diagnosis of Left Ventricular Failure in Chronic Obstructive Pulmonary Disease Exacerbation

14, 2012 Last Update Posted : September 24, 2013 Sponsor: University of Monastir Information provided by (Responsible Party): Nouira, University of Monastir Study Details Study Description Go to Brief Summary: Left ventricular failure (LVF) is a common cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This association is frequently underestimated with regard to the difficulty of clinical diagnosis . The investigators expect that Valsalva Maneuver (VM) could be useful (...) in this issue. Condition or disease Intervention/treatment Phase Acute Heart Failure COPD Exacerbation Other: Valsalva maneuver Not Applicable Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 150 participants Allocation: Non-Randomized Intervention Model: Single Group Assignment Masking: Single (Investigator) Primary Purpose: Diagnostic Official Title: Study of the Valsalva Manœuvre in the Diagnosis of Left Ventricular Failure During

2012 Clinical Trials

86. Valsalva maneuver to predict dynamic intraventricular obstruction during dobutamine stress echocardiography in patients with hypertension. (PubMed)

Valsalva maneuver to predict dynamic intraventricular obstruction during dobutamine stress echocardiography in patients with hypertension. We were to evaluate the effect of Valsalva maneuver with comparison to preload reduction by nitroglycerin (NTG) to predict intraventricular obstruction (IVO) during dobutamine stress echocardiography (DSE) in patients with hypertension.A total of 38 hypertensive patients (mean age 66.0±9.9 years; 32% male) were prospectively enrolled. The patients (...) interventricular septum thickness and higher basal septal thickness than non-IVO group. At rest, after Valsalva maneuver, during peak dose of dobutamine, and after NTG, IVPG was higher in IVO-group. To predict IVO during DSE, IVPG ≥5 mmHg after Valsalva maneuver had a sensitivity of 70.4% and specificity of 90.9%. and IVPG ≥4.5 mmHg after NTG had a sensitivity of 33.3% and specificity of 90.9%.Simple and safe Valsalva maneuver plays an effective role to predict dynamic IVO in patients with hypertension who

2010 International journal of cardiology

87. Ultrasound probe pressure but not maternal Valsalva maneuver alters Doppler parameters during fetal middle cerebral artery Doppler ultrasonography. (PubMed)

Ultrasound probe pressure but not maternal Valsalva maneuver alters Doppler parameters during fetal middle cerebral artery Doppler ultrasonography. To determine the effects of increased ultrasound probe pressure and maternal Valsalva maneuver (VM) on the middle cerebral artery (MCA) Doppler ultrasonography in fetuses.A total of 120 healthy pregnant women in second and third trimesters were enrolled in the study. MCA blood flow was measured by pulsed Doppler sonography in 60 fetuses (24 and 40

2010 Prenatal diagnosis

88. The Valsalva maneuver in Chagas disease patients without cardiopathy. (PubMed)

The Valsalva maneuver in Chagas disease patients without cardiopathy. To perform a meta-analysis of studies using the Valsalva ratio (VR) in Chagas disease (ChD) patients without cardiopathy in comparison to control subjects in order to determine if vagal heart modulation is impaired in early forms of ChD.The medical literature was systematically searched and reviewed for cross-sectional studies in humans in which the Valsalva maneuver was used to evaluate the autonomic modulation of the heart

2010 Clinical autonomic research : official journal of the Clinical Autonomic Research Society

89. Heat stress alters hemodynamic responses during the Valsalva maneuver (PubMed)

Heat stress alters hemodynamic responses during the Valsalva maneuver The Valsalva maneuver can be used as a noninvasive index of autonomic control of blood pressure and heart rate. The purpose of this investigation was to test the hypothesis that sympathetic mediated vasoconstriction, as referenced by hemodynamic responses during late phase II (phase IIb) of the Valsalva maneuver, is inhibited during whole body heating. Seven individuals (5 men, 2 women) performed three Valsalva maneuvers (...) (each at a 30-mmHg expiratory pressure for 15 s) during normothermia and again during whole body heating (increase sublingual temperature approximately 0.8 degrees C via water-perfused suit). Each Valsalva maneuver was separated by a minimum of 5 min. Beat-to-beat mean arterial blood pressure (MAP) and heart rate were measured during each Valsalva maneuver, and responses for each phase were averaged across the three Valsalva maneuvers for both thermal conditions. Baseline MAP was not significantly

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2010 Journal of Applied Physiology

90. Effect of beta-adrenergic blockade on beat-to-beat response to Valsalva manoeuvre. (PubMed)

Alprenolol pharmacology Cardiac Output drug effects Clinical Trials as Topic Electrocardiography Heart Rate drug effects Heart Ventricles drug effects Humans Male Placebos Reflex Time Factors Valsalva Maneuver 1974 11 1 1974 11 1 0 1 1974 11 1 0 0 ppublish 4615727 PMC458923 J Appl Physiol. 1966 Sep;21(5):1553-60 5332247 Circulation. 1967 Apr;35(4):653-61 5337274 Am Heart J. 1968 Jul;76(1):70-3 5659278 JAMA. 1969 Jul 14;209(2):239-42 5819228 Am Heart J. 1970 Dec;80(6):729-39 5477617 Cardiovasc Res. 1971 (...) Effect of beta-adrenergic blockade on beat-to-beat response to Valsalva manoeuvre. 4615727 1975 06 09 2018 11 13 0007-0769 36 11 1974 Nov British heart journal Br Heart J Effect of beta-adrenergic blockade on beat-to-beat response to Valsalva manoeuvre. 1082-6 Spodick D H DH Meyer M B MB Quarry-Pigott V M VM eng Clinical Trial Journal Article Randomized Controlled Trial Research Support, U.S. Gov't, Non-P.H.S. England Br Heart J 0370634 0007-0769 0 Placebos 877K5MQ27W Alprenolol AIM IM Adult

1975 British Heart Journal

91. Wegener's granulomatosis with abnormal arterial pressure response to the Valsalva manoeuvre. (PubMed)

Humans Male Middle Aged Pressoreceptors Valsalva Maneuver 1967 6 1 1967 6 1 0 1 1967 6 1 0 0 ppublish 6043694 PMC2466252 Am J Med. 1954 Aug;17(2):168-79 13180525 AMA Arch Pathol. 1954 Dec;58(6):533-53 13217569 Lancet. 1960 Mar 12;1(7124):559-62 14445609 Lancet. 1963 May 25;1(7291):1121-6 13969492 Brain. 1965 Mar;88:151-64 14280271 Br Med J. 1955 Mar 19;1(4915):693-5 14351748 J Clin Pathol. 1963 May;16(3):215-9 16811006 J Physiol. 1956 Oct 29;134(1):1-10 13377308 Br Med J. 1958 Aug 2;2(5091):265-70 (...) Wegener's granulomatosis with abnormal arterial pressure response to the Valsalva manoeuvre. 6043694 1967 11 14 2018 11 13 0032-5473 43 500 1967 Jun Postgraduate medical journal Postgrad Med J Wegener's granulomatosis with abnormal arterial pressure response to the Valsalva manoeuvre. 425-7 Holmes A M AM Stretton T B TB eng Journal Article England Postgrad Med J 0234135 0032-5473 IM Arteries Blood Pressure Granulomatosis with Polyangiitis complications physiopathology Heart Failure etiology

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1967 Postgraduate medical journal

92. Heart rate response to Valsalva manoeuvre. Reproducibility in normals, and relation to variation in resting heart rate in diabetics. (PubMed)

physiopathology Female Heart Rate Humans Male Middle Aged Valsalva Maneuver 1977 6 1 1977 6 1 0 1 1977 6 1 0 0 ppublish 884015 PMC483292 JAMA. 1963 Oct 19;186:200-5 14057108 Lancet. 1973 Dec 15;2(7842):1354-6 4128054 J Am Geriatr Soc. 1971 Feb;19(2):159-66 4322074 Br Med J. 1973 Dec 8;4(5892):584-6 4758519 Am J Cardiol. 1966 Jul;18(1):90-9 5938917 Br Heart J. 1975 Aug;37(8):882-5 1191450 Br Med J. 1975 Jul 5;3(5974):15-7 1131653 Diabetes. 1967 Jul;16(7):462-5 6028752 Brain. 1975 Sep;98(3):341-56 810214 (...) Heart rate response to Valsalva manoeuvre. Reproducibility in normals, and relation to variation in resting heart rate in diabetics. 884015 1977 09 22 2018 11 13 0007-0769 39 6 1977 Jun British heart journal Br Heart J Heart rate response to Valsalva manoeuvre. Reproducibility in normals, and relation to variation in resting heart rate in diabetics. 641-4 Baldwa V S VS Ewing D J DJ eng Journal Article England Br Heart J 0370634 0007-0769 AIM IM Adult Age Factors Aged Diabetes Mellitus

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1977 British Heart Journal

93. Usefulness of Valsalva manoeuvre and cold pressor test for evaluation of arrhythmias in long QT syndrome. (PubMed)

Arrhythmias, Cardiac diagnosis drug therapy physiopathology Cold Temperature Electrocardiography Exercise Test Female Heart Conduction System physiopathology Humans Propranolol therapeutic use Valsalva Maneuver 1979 10 1 1979 10 1 0 1 1979 10 1 0 0 ppublish 508482 PMC482189 Medicine (Baltimore). 1950 May;29(2):123-68 15416504 Clin Pediatr (Bologna). 1963 Sep;45:656-83 14158288 J Ir Med Assoc. 1964 Apr;54:103-6 14136838 Am Heart J. 1957 Jul;54(1):59-68 13435203 Am Heart J. 1975 Mar;89(3):378-90 234667 Am J (...) Usefulness of Valsalva manoeuvre and cold pressor test for evaluation of arrhythmias in long QT syndrome. 508482 1980 02 28 2018 11 13 0007-0769 42 4 1979 Oct British heart journal Br Heart J Usefulness of Valsalva manoeuvre and cold pressor test for evaluation of arrhythmias in long QT syndrome. 490-2 Rubin S A SA Brundage B B Mayer W W Chatterjee K K eng Case Reports Journal Article Research Support, U.S. Gov't, P.H.S. England Br Heart J 0370634 0007-0769 9Y8NXQ24VQ Propranolol AIM IM Adult

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1979 British Heart Journal

94. THE EFFECT OF THE VALSALVA MANÅ’UVRE ON THE SYSTEMIC AND PULMONARY ARTERIAL PRESSURE IN MAN (PubMed)

Valsalva Maneuver 5426:45076:44:72 ARTERIES, PULMONARY/physiology BLOOD PRESSURE/physiology 1954 7 1 1954 7 1 0 1 1954 7 1 0 0 ppublish 13182148 PMC479530 J Physiol. 1953 Nov 28;122(2):351-7 13118544 J Appl Physiol. 1951 Nov;4(5):345-50 14938263 Am J Physiol. 1951 May;165(2):261-77 14838110 J Clin Invest. 1950 Jun;29(6):818-9 15436744 Lancet. 1952 Jul 19;2(6725):109-11 14939847 Circulation. 1952 Feb;5(2):263-70 14896471 (...) THE EFFECT OF THE VALSALVA MANÅ’UVRE ON THE SYSTEMIC AND PULMONARY ARTERIAL PRESSURE IN MAN 13182148 2003 05 01 2018 12 01 0007-0769 16 3 1954 Jul British heart journal Br Heart J The effect of the Valsalva manoeuver on the systemic and pulmonary arterial pressure in man. 311-6 DE LEE G J GJ MATTHEWS M B MB SHARPEY-SCHAFER E P EP eng Journal Article England Br Heart J 0370634 0007-0769 OM Arteries Blood Pressure physiology Blood Pressure Determination Humans Lung Pulmonary Artery physiology

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1954 British Heart Journal

95. Effects of Valsalva's Manœuvre on the Normal and Failing Circulation (PubMed)

Effects of Valsalva's Manœuvre on the Normal and Failing Circulation 14351748 2003 05 01 2018 12 01 0007-1447 1 4915 1955 Mar 19 British medical journal Br Med J Effects of Valsalva's manoeuvre on the normal and failing circulation. 693-5 SHARPEY-SCHAFER E P EP eng Journal Article England Br Med J 0372673 0007-1447 OM Blood Pressure physiology Blood Pressure Determination Heart Failure physiology Humans Respiration physiology Shock Valsalva Maneuver 5528:2414:92:152:491 BLOOD PRESSURE

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1955 British medical journal

96. THE VALSALVA MANÅ’UVRE IN AORTIC VALVE DISEASE (PubMed)

THE VALSALVA MANÅ’UVRE IN AORTIC VALVE DISEASE 13471819 2000 07 01 2018 12 01 0007-0769 19 4 1957 Oct British heart journal Br Heart J The Valsalva manoeuvre in aortic valve disease. 525-31 DOYLE A E AE NEILSON G H GH eng Journal Article England Br Heart J 0370634 0007-0769 0 Aortic Valve Disease 1 OM Aortic Valve Aortic Valve Stenosis Blood Pressure Constriction, Pathologic Heart Defects, Congenital Heart Valve Diseases Humans Valsalva Maneuver 5833:14708:47:79 AORTIC VALVE/stenosis BLOOD

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1957 British Heart Journal

97. VENOUS DISTENSIBILITY OF THE HAND DURING VALSALVA'S MANÅ’UVRE (PubMed)

VENOUS DISTENSIBILITY OF THE HAND DURING VALSALVA'S MANÅ’UVRE 14005320 1998 11 01 2018 12 01 0007-0769 24 1962 Jan British heart journal Br Heart J Venous distensibility of the hand during Valsalva's manoeuvre. 26-30 WATSON W E WE eng Journal Article England Br Heart J 0370634 0007-0769 OM Blood Pressure physiology Blood Pressure Determination Hand blood supply Humans Pressure Valsalva Maneuver Veins BLOOD PRESSURE/physiology HAND/blood supply 1962 1 1 1962 1 1 0 1 1962 1 1 0 0 ppublish

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1962 British Heart Journal

98. SOME CIRCULATORY RESPONSES TO VALSALVA'S MANOEUVRE IN PATIENTS WITH POLYNEURITIS AND SPINAL CORD DISEASE (PubMed)

physiology Neuritis physiology Pressure Spinal Cord Diseases Valsalva Maneuver BLOOD CIRCULATION/physiology BLOOD PRESSURE/physiology POLYNEURITIS/physiology SPINAL CORD/diseases 1962 2 1 1962 2 1 0 1 1962 2 1 0 0 ppublish 14005316 PMC495411 J Physiol. 1953 Nov 28;122(2):351-7 13118544 Lancet. 1956 Apr 28;270(6922):539-41 13320798 Lancet. 1956 Dec 15;271(6955):1247-8 13386221 J Clin Invest. 1954 May;33(5):798-806 13163171 J Physiol. 1958 Jan 23;140(1):113-21 13514654 J Physiol. 1958 Jan 23;140(1):122-8 (...) SOME CIRCULATORY RESPONSES TO VALSALVA'S MANOEUVRE IN PATIENTS WITH POLYNEURITIS AND SPINAL CORD DISEASE 14005316 1998 11 01 2018 12 01 0022-3050 25 1962 Feb Journal of neurology, neurosurgery, and psychiatry J. Neurol. Neurosurg. Psychiatry Some circulatory responses to Valsalva's manoeuvre in patients with polyneuritis and spinal cord disease. 19-23 WATSON W E WE eng Journal Article England J Neurol Neurosurg Psychiatry 2985191R 0022-3050 OM Blood Circulation physiology Blood Pressure

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1962 Journal of neurology, neurosurgery, and psychiatry

99. The effect of graded doses of practolol on the tachycardia induced by isoprenaline, Valsalva's manoeuvre and exercise. (PubMed)

Sympatholytics L628TT009W Isoproterenol IM Acetanilides administration & dosage Adrenergic beta-Antagonists administration & dosage Heart Rate drug effects Humans Isoproterenol antagonists & inhibitors Physical Exertion Sympatholytics administration & dosage Valsalva Maneuver 1970 5 1 1970 5 1 0 1 1970 5 1 0 0 ppublish 4392962 PMC1703059 Br J Pharmacol. 1968 Sep;34(1):127-40 4877600 Lancet. 1964 Feb 8;1(7328):296-300 14089056 (...) The effect of graded doses of practolol on the tachycardia induced by isoprenaline, Valsalva's manoeuvre and exercise. 4392962 1970 07 29 2018 11 13 0007-1188 39 1 1970 May British journal of pharmacology Br. J. Pharmacol. The effect of graded doses of practolol on the tachycardia induced by isoprenaline, Valsalva's manoeuvre and exercise. 193P-194P Aellig W H WH Prichard B N BN eng Journal Article England Br J Pharmacol 7502536 0007-1188 0 Acetanilides 0 Adrenergic beta-Antagonists 0

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1970 British journal of pharmacology

100. Valsalva hemorrhagic retinopathy. (PubMed)

Valsalva hemorrhagic retinopathy. 4663671 1973 08 28 2018 11 13 0065-9533 70 1972 Transactions of the American Ophthalmological Society Trans Am Ophthalmol Soc Valsalva hemorrhagic retinopathy. 298-313 Duane T D TD eng Journal Article United States Trans Am Ophthalmol Soc 7506106 0065-9533 IM Adult Angioid Streaks etiology Eye Injuries complications Female Humans Male Middle Aged Retinal Hemorrhage etiology physiopathology Retinal Vessels injuries Valsalva Maneuver Vision, Ocular 1972 1 1 1972

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1972 Transactions of the American Ophthalmological Society

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