Valsalva Maneuver

Overview

The Valsalva maneuver is a technique that is often used to diagnose autonomic nervous system (ANS) issues, clear clogged ears, and helps restore abnormal heart rate.

When performing the technique, you will try to exhale when your airways are blocked. You will close your mouth and pinch your nose and bear down to exhale through the airways.

A Valsalva maneuver should be tried under a doctor's supervision.

Candidates for the Valsalva maneuver

Your doctor may recommend the Valsalva maneuver in the following cases:

• Diagnose an ANS disorder - your doctor may ask you to perform a Valsalva maneuver to identify if you have a disorder called postural orthostatic tachycardia syndrome (POTS). If you have POTS, your blood pressure will drop dramatically during the maneuver. POTS is a serious health condition that could lead to fainting, falls, or other complications.
• Treat clogged ears - the Valsalva maneuver can also be used to clear your ears if air is blocking the Eustachian tube in the inner ear. The maneuver helps your ears pop by forcing air through the sinuses and Eustachian tube.
• Restore heart rhythm - the Valsalva maneuver may be used to restore your normal heart rhythm if you are experiencing tachycardia (abnormally fast heartbeat).

Risks associated with the Valsalva maneuver

While a Valsalva maneuver is generally safe. Use caution and follow your doctor’s instructions carefully when you perform it. If you push too hard while trying to exhale, you could burst an eardrum.

Preparing for the Valsalva maneuver

Before trying the Valsalva maneuver for the first time, perform it for the first time with your clinician. Once he or she determines you are performing it safely, you can do it as needed when you experience symptoms.

Expectations during the Valsalva maneuver

There are four phases of the Valsalva maneuver.

Phase 1

During phase 1, you will exhale your air forcefully against your closed airways. You will hold this position for 10 seconds. This action will cause the pressure in your chest to increase, which leads to a temporary blood pressure spike.

Phase 2

During phase 2, your blood pressure will drop as the flow of blood back to the heart is reduced. As the ANS senses the drop in blood pressure and increases the heart rate and output, which contracts the arteries.

Phase 3

During phase 3, at the end of the maneuver, your body will relax, causing your blood pressure to drop.

Phase 4

During phase 4, blood rushes back to the heart. Your blood pressure will rise as the blood flow returns to normal while vessels are still constricted. The increase in blood pressure helps the heart rate to return to normal.

Recovery from the Valsalva maneuver

A Valsalva maneuver is performed in a clinic during a visit with your doctor. If there are no complications, you will go home after the clinic visit. You can resume your normal activities that day.