How does the Valsalva (Valsalva maneuver) maneuver affect abdominal pressure?

From the Guidelines

The Valsalva maneuver significantly increases abdominal pressure due to the forceful contraction of abdominal muscles against a closed airway. This increase in abdominal pressure is a result of the physiological response to the maneuver, where the diaphragm pushes downward and the abdominal muscles contract, compressing the thoracic and abdominal contents against the closed glottis 1. The Valsalva maneuver can be described as a modified expiratory phase, similar to coughing, which can generate high expiratory velocities and pressures, including intrathoracic pressures of up to 300 mm Hg 1.

Some key points to consider when evaluating the effect of the Valsalva maneuver on abdominal pressure include:

• The physiological events involved in the maneuver, including the contraction of thoracic and abdominal musculature against a fixed diaphragm 1
• The potential for increased intrathoracic pressure and expiratory velocities, which can affect cardiovascular function and overall health-related quality of life 1
• The importance of considering the potential risks and benefits of the Valsalva maneuver, particularly in patients with certain cardiovascular conditions or other health concerns 1

Overall, the Valsalva maneuver has a significant impact on abdominal pressure, and its effects should be carefully considered in various medical contexts.

From the Research

Effect of Valsalva Maneuver on Abdominal Pressure

• The Valsalva maneuver is associated with increased intrathoracic and abdominal pressure, leading to hemodynamic changes 2.
• The maneuver consists of a voluntary forced expiratory effort against a closed upper airway, which increases abdominal pressure 2.
• Abdominal compression has been shown to be similar to an optimal Valsalva maneuver for increasing right atrial pressure and thus the right-to-left pressure gradient 3.
• The Valsalva maneuver alone increases intra-abdominal pressure (IAP), and this increase is augmented during various resistance exercises 4.
• The role of the abdominal musculature in developing an increased IAP during specified tasks, including the Valsalva maneuver, has been evaluated, showing that IAPs are markedly greater than those that occur while relaxed 5.

Hemodynamic Effects

• The Valsalva maneuver is associated with an increase in blood pressure during resistance exercise, but the maneuver alone is associated with greater hemodynamic changes 4.
• The health risks associated with the Valsalva maneuver during resistance exercise remain unconfirmed 4.
• The Valsalva maneuver can exacerbate left atrial compression in patients with large hiatal hernia, decreasing left atrial and left ventricular dimensions 6.

Clinical Implications

• The Valsalva maneuver may assist with spine stability and trunk rigidity during resistance exercise due to the increase in IAP 4.
• Conditions associated with decreased preload and increased intra-abdominal pressure may exacerbate the cardiac effects of large hiatal hernia 6.
• The Valsalva maneuver can be used to facilitate elevation of right atrial pressure, but alternative methods such as abdominal compression may be used in certain situations 3.