1 of 4 Vagal Maneuvers
Mechanism:
- Increased intra-thoracic pressure causes decreases venous return, decreasing preload and thereby reducing EDV.
Contraindications:
- Requirement for immediate cardioversion (hemodynamic instability)
- Hypotension (SBP < 90 mmHG)
- Atrial fibrillation/flutter
- Aortic Stenosis
- Recent myocardial infarction (within 3 months)
- Glaucoma
- Retinopathy
- Third trimester of pregnancy
- Link
Indications:
Heart Murmurs:
- Aortic Stenosis DECREASES (less preload = reduced EDV = less blood going through making noise)
- HOCM increases (reduced EDV increases the obstruction)
Termination of Arrythmias:
- Initial treatment for hemodynamically stable SVT
Cardiovascular changes occur during and after this maneuver due to baroreflex and other compensatory reflex mechanisms initiated by decreased preload.
Valsalva maneuver can be utilized to assess autonomic function, evaluate heart failure, terminate supraventricular tachycardia, and differentiate cardiac murmurs.