The Valsalva maneuver and response revisited.

The Valsalva maneuver is a time-honored technique that is commonly used at the bedside for the evaluation of heart murmurs. It is also a valuable adjunct in the evaluation of left ventricular function and autonomic dysfunction. In this article, we describe the normal and abnormal responses to the Valsalva maneuver and provide insight into the underlying hemodynamics in conditions that provoke an abnormal response.