Valsalva Maneuver

Definition

The Valsalva maneuver is the act of bearing down (forced exhalation against a closed glottis), which increases intrathoracic and intra-abdominal pressure. It can temporarily slow heart rate by vagal stimulation.

Therapeutic Uses

• Convert SVT to normal sinus rhythm
• Assess cardiac murmurs
• Equalize ear pressure

Contraindications

AVOID in patients with:

• Increased intracranial pressure (may worsen)
• Glaucoma (elevates IOP)
• Recent eye surgery
• Heart failure (decreases venous return)
• Post-MI (increases cardiac workload)
• Hernia (worsens)
• Abdominal aneurysm (rupture risk)
• Hemorrhoids

Nursing Teaching

Avoid straining during bowel movements (use stool softeners). Avoid heavy lifting. Don't hold breath during exertion, for SVT, Valsalva (vagal maneuver) is first-line. Coughing, blowing into syringe, modified Valsalva.

NCLEX Relevance

Avoid Valsalva in increased ICP, glaucoma, CHF.