The test for cardiac function here described consists of having the patient blow into a manometric system in such a way as to maintain an intrapulmonic pressure of 40 mm. Hg for 10 seconds. During and immediately after this straining period the patient's blood pressure is noted. A four-phase response, consisting of a brief rise of 30 to 50 mm. Hg in systolic blood pressure, a gradual fall to resting level, a brief fall below resting level when the strain is released, and a secondary rise of 15 to 40 mm., is considered a normal response. The test was applied to 205 selected office patients. Positive results (abnormal responses) were obtained in 35. Of these, 14 showed clinical signs of congestive heart failure and 11 had significant heart disease.
Irvin CW. VALSALVA MANEUVER AS A DIAGNOSTIC AID. JAMA. 1959;170(7):787–791. doi:10.1001/jama.1959.03010070027007
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