Valsalva Manuever

[busybee10]

During the Valsalva Manuever,do the heart rate changes do they precede or follow the blood pressure changes? How is this so? Is there a cause and effect relationship?

[LindaTX]

Thanks, kenkeith, that explanation does help a lot. I guess basically I've just never paid any attention to the correlation of the diastolic pressure to the systolic because I've never had any problems with my BP.  

[kenkeith]

Its a matter of maintaining a balance of blood flow between the right and left side of the heart.
When veins expand, more blood can be stored in the veins and less blood returns to the heart for pumping into the arteries. As a result, the heart pumps less blood, and blood pressure is lower. On the other hand, when veins narrow, less blood is stored in the veins, more blood returns to the heart for pumping into the arteries, and blood pressure is higher

[LindaTX]

Ok, this is for anybody who can give me a short simple answer. I don't have the energy to read ed's post above, but I will .....as soon as I go out of a-fib and back intp NSR.  Whn I am in a-fib, my blood pressure gets in a rut.  My systolic remains in the  normal range but my diastolic stays within 20 to 30 pts of my systolic.  If I can get my diastolic to go down to where there is at least a 40 pt differential then I will go back out of a-fib. Does anyone know how I can make just my diastolic go down?

[ed34]

The 4 phases are.
When you put pressure on the lungs, pressure rises in the chest forcing blood out of the pulmonary circulation into the left atrium. This causes a slight increase in EF and sudden drop in bp.

Return of systemic blood to the heart is restricted due to the chest pressure. Now EF is
reduced. This happens between 5-14 seconds from the start of the procedure. Blood vessels constrict, raising pressure back to normal but flow and EF remain low, but the heart rate will usually increase.

When the air is exhaled and pressure is removed off the pulmonary arteries and the aorta, there is another sudden drop in EF due to the decreased supply to the left ventricle and the suddenly expanded aorta. Venous blood is now able to re-enter the heart and so EF begins to increase.

Blood supply is suddenly increased to the heart due to the 'dammed' blood being suddenly released and this causes a rapid increase in EF. EF at this stage will usually be above normal before gradually returning to normal again. Blood pressure returns to normal with the EF and the heart rate soon follows.

This test, if it shows abnormalities, shows there is a heart function problem or a problem with the autonomic nervous control.

This procedure is used by divers to equalise the pressure in their ears, but a very short burst. Isn't doing this procedure for many seconds rather risky at home without supervision of a cardiologist? just wondering.

[ed34]

Sorry if I was confusing. I wasn't saying that blood pressure drove it, I was simply saying what happens to blood pressure during the procedure. That's if you was refering to me? there is no 'TO' name in your post

[itdood]

Vagal maneuvers like the valsalva maneuver lengthen the heart's QT interval.  No one is sure exactly why this happens, it's thought to be a result of stimulation of the para sympathetic nerves.   It can break an attack of SVT, or in risky patients can be used to evaluate risk of v-tach.

I've used it on myself for SVT and it'll break the SVT when I exhale,release the pressue, my heart rate will drop 50-60 bpm literally in a heart beat.

I'm guessing the change follows the "blood pressure" change, but I've never heard that the heart's repsonse to a vagal manauever is driven by blood pressure.  I thought it was more of a sympathetic nervous reponse, sorta like the diving reflex.  For instance, one of the vagal manauvers is dunking one's face into cold water, this can also break SVT.  There's no blood pressue changes there but it has the same effect as the valsalva manauever.

[ed34]

At first there is a sudden drop in pressure due to the heart being impeded, but blood vessels quickly constrict, raising pressure, usually to normal or just above normal. After  about 30 seconds (from stopping the procedure), the volume of blood expelled by the heart should return to normal and blood pressure with it.

[ireneo]

I've use valsalva for over 30 years and never thought about the BP changes that might be involved. I just know that when my heart is tachy and I use the maneuver, I can feel my heart rate/rhythm change during the maneuver (gets erratic) and then when I slowly release my breath, the rhythm kicks back to normal. At that moment all that matters to me is getting the rate to come back down. BP is not on my mind.