Valsalva maneuver /valsal″və/ [Antonio M. Valsalva, Italian surgeon, 1666–1723; OFr, maneuvre, work done by hand] , any forced expiratory effort against a closed airway, such as when an individual holds the breath and tightens the muscles in a concerted, strenuous effort to move a heavy object. Most healthy individuals perform Valsalva maneuvers during normal daily activities without any injurious consequences. However, such efforts are dangerous for many patients with cardiovascular disease, especially if they become dehydrated, increasing the viscosity of their blood and the attendant risk of blood clotting. Constipation increases the risk of cardiovascular trauma in such patients, especially if they perform a Valsalva maneuver in trying to move their bowels. On relaxation after each muscular effort with held breath, the blood of such individuals rushes to the heart, often overloading the cardiac system and causing cardiac arrest. Orthopedic patients often use a Valsalva maneuver in changing their position in bed with the aid of an overhead trapeze bar. Patients who may be endangered by performing a Valsalva maneuver are commonly instructed to exhale instead of holding their breath when they move. Exhalation decreases the risk of cardiovascular trauma. Part of the danger is a bradycardia response.
