Have you ever felt your heart pounding and racing when you were at a loss? Sometimes it can be a little scary, right? Today we're going to talk about a very simple way to relieve this type of heart rate, medically known as Supraventricular Tachycardia (SVT) , without medication, and in many cases as a first step. This is called the 'Valsalva maneuver.'
Simply put, what is the Valsalva Maneuver?
This may sound like a strange name, but it's actually quite simple. Simply put, the Valsalva maneuver involves taking a deep breath, closing your mouth and nose, and forcing the air out. It feels like you're straining to defecate when you go to the toilet.
Imagine that your heart rate suddenly increases. Then when you go to the doctor, before he prescribes medication or refers you to another treatment, he might suggest you try this method. The reason is that it is a very quick and simple method that is noninvasive, meaning that nothing is inserted into the body.
But one thing you should keep in mind is that this is not something you can do on your own. You should only do this if your doctor has examined your condition and advised you that this method is suitable for you. Because only a doctor can know for sure whether your heart rhythm abnormality is one that will respond to this method.
What kind of things is this method used for?
Doctors use the Valsalva maneuver to diagnose and treat diseases. Let's look at some of its benefits. The table below will make this clearer.
| Benefit | Description |
|---|---|
| Controlling the heartbeat | As mentioned above, this helps control the condition of sudden rapid heartbeat (SVT) and restore it to a normal rhythm. |
| Identifying heart murmurs | This method helps a doctor identify exactly what type of abnormal sounds (heart murmurs) are heard when examining a heart with a stethoscope. |
| Heart Failure Diagnosis | This can be used in the diagnostic process to identify some heart conditions. |
| Diagnosis of other diseases | It is also used to diagnose conditions such as venous disease or varicocele. |
| Autonomic nervous system problems | This also helps to detect any problems with the Autonomic Nervous System, which controls things like our heartbeat and breathing without us realizing it. |
Who should not perform the Valsalva Maneuver?
Although this is a simple method, it is not suitable for everyone. Because when doing this method, the pressure inside our eyes and stomach increases immediately. Therefore, people with certain medical conditions should avoid doing this.
If you have any of the following conditions, never try this without consulting a doctor.
| Condition | Why be careful? (Why be careful?) |
|---|---|
| Retinal diseases | If you have a condition such as retinopathy , which is a problem with the blood vessels in the retina, this procedure can cause damage due to increased pressure inside the eye. |
| Eye lens implants | This is not a good idea if you have an intraocular lens inserted after a cataract surgery. The increased pressure can affect the lens. |
| Heart valve disease | People with heart valve weakness or disease may have difficulty tolerating the pressure changes that occur with this procedure. |
| Coronary artery disease | If there are blockages in the veins that supply blood to the heart, this method can cause unnecessary pressure on the heart. |
| Congenital heart disease | This method may also not be suitable for people with congenital heart disease, so it is essential to discuss this with your doctor. |
How exactly do you do this?
Okay, now let's see how exactly to do it if a doctor tells you to do this. You need to follow these steps in order.
Imagine that you are watching TV and suddenly your chest starts to pound. If your doctor has taught you this method, you can do this while lying down calmly on a bed or sofa, or sitting in a chair.
1. Step 1: First , sit or lie down calmly. Don't panic.
2. Step 2: Take a deep breath as usual.
3. Step 3 (the most important part): Now close your mouth tightly. Also, pinch your nose shut with two fingers. Then, tighten your abdominal muscles and strain them as if you are trying to push the breath out. Just like straining to have a bowel movement.
4. Step Four: Hold this position for about 15 to 20 seconds.
5. Step Five: Now suddenly open your nose and mouth and start breathing normally.
This method is successful if your heart rate returns to normal within about a minute.
Two special methods
There are two small changes that doctors use to make this a little more successful.
- Modified Valsalva Maneuver: In this method, once you have finished squeezing, your doctor or someone else will lift your legs. This will help the blood in your legs flow back to your heart more quickly. This will help your heart rate return to normal. One study found that the standard method has a 46% success rate, compared to a 16% success rate for the modified method.
- Reverse Valsalva Maneuver: This is a bit of a reverse. You sit down, close your mouth and nose, and inhale for about 10 seconds.
What happens inside the body when you do this?
When you squeeze it like this, a chain of events occurs inside your body. It's very interesting.
- First: When you squeeze, your blood pressure will immediately increase slightly because the pressure inside your chest increases.
- Next: When you hold it in, the amount of blood that goes to the heart decreases. This causes blood pressure to drop. In response, the heart beats faster.
- After you stop squeezing: When you suddenly let go of your breath, your blood pressure drops a little more.
- Finally (and most importantly): Then, the body responds by suddenly increasing blood pressure to a higher level than before. This is called the 'rebound effect'. When this pressure increases, the nervous system responds by sending a signal to the heart to slow down. This final step is what we need. The heart rate slows down and returns to normal.
Results, benefits and risks
How are the results?
The success rate of the Valsalva maneuver is between 5% and 20%, meaning it doesn't always work.
If your heart rate doesn't return to normal after about three attempts, your doctor will move on to the next step in treatment. This may include massaging a special vein in your neck (carotid massage), giving you medication, or giving you an electric shock (cardioversion) . This will depend on your symptoms and the severity of your condition.
What are the advantages of this?
- This is a very quick method.
- Something that can be done without medication .
- If successful, you can avoid the side effects that can occur from medications or other treatments.
Are there any risks or side effects?
Most people can do this safely without any complications, but there are a few things that can happen very rarely .
- Chest pain
- Fainting (loss of consciousness)
- Abnormal heart rhythm
- Stroke
Although these are very rare events, this is why we say that this should always be done only under medical advice .
When should I see the doctor?
If your doctor has taught you this method for SVT and instructed you to do it at home, and you try it but your heart rate does not return to normal, you should call your doctor immediately. He or she will tell you what to do next. You may be asked to go to the hospital's emergency department (ETU) immediately.
The Valsalva maneuver is a useful tool, but it doesn't always work, so it's important to talk to your doctor about what to do next.
Take-Home Message
- The Valsalva Maneuver is a specialized technique used to treat certain conditions, such as supraventricular tachycardia (SVT). It is not intended for general use.
- Never try this on your own or after looking it up on the internet. Only do it if your doctor has examined your condition, said it is appropriate for you, and instructed you on how to do it properly.
- If you have eye disease, heart valve disease, or other heart conditions, this procedure may not be suitable for you. Tell your doctor your complete medical history.
- If you have tried this as your doctor advised and it doesn't work, don't panic. This is normal. Tell your doctor right away. They will guide you on the next treatment steps.
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