Valsalvas???

[macca61]

Hi,

what exactly does a 'positive' valsavas procedure mean, in connection to the heart ???

thanks

[abc85]

I'm guessing that they had him do a valsalva maneuver which typically involves bearing down hard like you are trying to have a bowel movement.  This causes the vagus nerve to slow down the HR.  I'm guessing that while he did this, they saw an increase in the J point elevation or ST elevation in the leads on his ECG that show early repolarization or if he didn't have any evidence of repolarization prior that, it unmasked this.  This may mean that he has ERS, which is something that has had a lot of research in the past decade as it has been linked to SCD and VF.  The fact that he is usually bradycardic also goes with ERS as those with it are typically bradycardic.  Some researchers in France investigated using the valsalva maneuver in screening for familial ERS which may be what your Dr was doing.  There hasn't been a ton of research involving ERS and the valsava maneuver so asking your Dr what this means might be the best bet at this point.

[macca61]

Hello again
thanks for that, but I don't this ties  in with his symptoms, usually bradycardic, suddenly feels very tired and has to sit or fall down. He has a follow up  appointment soon with his cardio. and  I am exploring all avenues/questions  so that I can prepare my  own list of questions when we go,I hope that makes sense...

[MichelleP_3811]

I am not a doctor but I believe it means his vagus nerve is part of the issue with his syncope.  the vagus nerve gets over stimulated and the heart can't keep up or something like that.  I would follow up with the doctor if this simply means to avoid certain things or if medications will help alleviate his problem.

[macca61]

Hi,
thanks for your reply   my son had a drugs challenge for  ERS and syncope,  the results ruled out Brugada,  but in the report it said  during the manouver of valsalvas his ERS was aggravated significantly.. I would like to know in what context does it mean..thanks

[MichelleP_3811]

This seems a bit vague to me.  Did you go for tests or were you in the ER for something like a rapid beat?  Did you have a tilt table test done? It sounds like you may have tested positive for a vagus nerve issue where if the vagus nerve is overstimulated it causes the body's blood vessels to dilate and the heart to slow down causing  person to pass out or near pass out.  This isn't uncommon to happen to people under certain conditions but if it happens often it could mean there is a possible dysautonmia issue present.  If you were in the ER for a rapid beat did they teach you how to stop the fast beat by holding your breath and bearing down.  That is called a vasovagal maneuver and I could see that the statement meant you successfully did it.  But I am not clear on what the comment is in relations to so what you stated could be something else as well.