title: Valsalva maneuver in echocardiography.
abstract: The Valsalva maneuver is an easily performed maneuver with an interesting hemodynamic effect which can be used to aid accurate echocardiographic diagnosis. However, correct adequate performance is often missed. Here, we aim to describe the performance of an adequate Valsalva maneuver and the correct interpretation of its effect. The Valsalva hemodynamic effect consists of four basic phases which can be used in echocardiography to yield an accurate diagnosis. Valsalva is used to decrease preload and provoke left ventricular outflow tract (LVOT) gradient in dynamic LVOT obstruction. In addition, a decrease in E/A ratio in mitral inflow >50 % with Valsalva correlates with increased LV filling pressure and diastolic dysfunction. Valsalva also momentarily increases RA pressure and helps to unmask a patent foramen ovale with the use of saline contrast.
authors: Cardiology Division, Internal Medicine Department, King Fahd Hospital of the University, University of Dammam, P.O. Box 2208, Al-Khobar, 31952, Saudi Arabia. sghazal@uod.edu.sa.
authors: Sami Nimer
authors: 0000-0002-7522-3220
authors: SN
authors: Ghazal
mesh_terms: D003971:Diastole; D015150:Echocardiography, Doppler / Q000379:methods*; D054092:Foramen Ovale, Patent / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006439:Hemodynamics; D006801:Humans; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014636:Valsalva Maneuver
keywords: Diastolic function; Doppler; Echocardiography; Valsalva