The Valsalva maneuver is a breathing technique that involves pinching your nose and breathing out forcefully with your mouth closed. This can help slow your heart rate and temporarily increase pressure in the throat, sinuses, and inner ears.
The Valsalva maneuver has several practical uses in medicine and in everyday life. For instance, it is often used to cure hiccups and help scuba divers adjust to water pressure changes. Cardiologists often recommend the Valsalva maneuver to patients who have episodes of certain kinds ofsupraventricular tachycardia (SVT). The technique can stop the arrhythmia when it occurs.
This article will explain how to do the Valsalva maneuver, the effects it has on the body physiologically, and its medical and non-medical uses.
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How the Valsalva Maneuver Is Done
The maneuver must be maintained a little longer in order to also achieve an increase in vagal tone, at least for 10 to 15 seconds.
What It Does
The Valsalva maneuver greatly increases pressures inside the nasal sinuses, and especially in the chest cavity. In simple terms, the elevated chest pressure stimulates thevagus nerveand increases vagal tone.
However, the Valsalva maneuver actually produces a fairly complex series of physiological events that doctors have employed over the years for several purposes.
Phases of the Valsalva Maneuver
Uses
Doctors find the Valsalva maneuver useful in distinguishing among various kinds ofvalvular heart disease.Most heart murmurs will diminish during phase 2 of the Valsalva maneuver since less blood is flowing through the heart at this time. But the murmurs associated with bothmitral valve prolapseandhypertrophic cardiomyopathywill often increase during phase 2 of the Valsalva maneuver. (With these two kinds of heart problems, less blood in the heart actually increases the amount of obstruction to blood flow, so the murmurs tend to become louder.)
Speaking more practically, the chief medical use of the Valsalva maneuver is to suddenly increase vagal tone (which also occurs mainly during phase 2). Increasing vagal tone slows the conduction of thecardiac electrical impulsethrough theAV node, and this transient slowed conduction is quite useful in terminating some types of SVT (in particular,AV-nodal reentrant tachycardiaandatrioventricular reentrant tachycardia).
Urologists may use the Valsalva maneuver to help them diagnose stress incontinence since the elevated abdominal pressure this technique produces can provoke urinary leakage.
A Word From Verywell
The Valsalva maneuver is a method of transiently increasing pressure within the sinuses and middle ears, and of increasing vagal tone. It has practical applications in the practice of medicine and in daily life.
Frequently Asked QuestionsTry the following steps:Take a breath.Close your mouth.Hold your nose closed.Try to exhale, like you’re blowing up a balloon.Bear down, like when you have a bowel movement.Hold for 10 to 15 seconds.Check with your doctor before doing the Valsalva maneuver if you have high blood pressure or heart disease. That’s because it can cause a sudden increase in blood pressure and strain the heart.
Frequently Asked Questions
Try the following steps:Take a breath.Close your mouth.Hold your nose closed.Try to exhale, like you’re blowing up a balloon.Bear down, like when you have a bowel movement.Hold for 10 to 15 seconds.
Try the following steps:
Check with your doctor before doing the Valsalva maneuver if you have high blood pressure or heart disease. That’s because it can cause a sudden increase in blood pressure and strain the heart.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Srivastav S, Jamil RT, Zeltser R.Valsalva maneuver. In: StatPearls. Treasure Island (FL): StatPearls Publishing.
Appelboam A, Reuben A, Mann C, et al.Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial.Lancet.2015 Oct 31;386(10005):1747-53. doi:10.1016/S0140-6736(15)61485-4.
Mercy Health.Valsalva maneuver.
American Heart Association.Congenital heart defects and physical activity.
Page RL, Joglar JA, Caldwell MA, et al. 2015 ACC/AHA/HRSGuideline for the management of adult patients with supraventricular tachycardia: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.Circulation. 2016;133(14):e471-505. doi:10.1161/CIR.0000000000000310
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