THE VALSALVA MANOEUVRE IN AORTIC VALVE DISEASE

Abstract

Forty patients with aortic valve disease were studied for the effect of the Valsalva maneuver on the arterial pressure pulse with particular reference to the relationship between the variations in systolic upstroke time and pulse pressure. Although in aortic stenosis the systolic upstroke time was usually pro- longed and the pulse pressure was often low, it was felt that neither measurement alone correlated well with the severity of the stenosis. Following the Valsalva maneuver or in atrial fibrillation, it was noted that in general the greater the change in upstroke time for a given change in pulse pressure, the more severe the stenosis was likely to be. This was a linear relationship. The fall of pulse pressure during the Valsalva maneuver was probably due to the fall in stroke volume. In severe stenosis, the upstroke time changes more than in milder stenosis for a given change in pulse pressure.