• Journal of Korean Academy of Nursing
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• v.16 no.1
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• pp.49-54
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• 1986

As patients on bed rest perform repeated Valsalva maneuver, it is necessary for them to prevent the-danger inherent in repeated Valsalva maneuver through intelligent rehabilitative nursing care. In this regard, it seems to be important to furnish a scientific rationale underlying rehabilitative nursing care. This study was undertaken to find the effects of repeated Valsalva maneuver upon circulation of nor-mal men. The subjects for this study were twenty normal and healthy college students of age from 19 to 26. For the first time, the ECG of standard 12 leads was recorded and the blood pressure was measured under the resting state. And the subjects performed Valsalva maneuver for 10 seconds, then expired air for 2 seconds. After the subjects carried out in this menner for 1 minute, the ECG and the blood pres-sure were recorded and measured again. The Changes of heartbeats, systolic and diastolic pressures after the practice of repeated Valsalva maneuver were compared with those of the letting state. The results obtained were as follows : 1. The heartbeats after the practice of repeated Valsalva maneuver generally increased but did not show statistical significance. 2. The systolic pressure measured after the practice of repeated Valsalva maneuver was higher than that of the resting state. 3. The diastolic pressure measured after the practice of repeated Valsalva maneuver was higher than that of the resting state.

• Physical Therapy Korea
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• v.5 no.1
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• pp.30-43
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• 1998

The purposes of this study were to examine the effect of two different pelvic alignments and the Valsalva maneuver on electromyographic (EMG) activity of the erector spinae during squat lifting and lowering, and to find an efficient method for squat lifting and lowering. Twenty hea1thy men in their twenties lifted and lowered loads using four different methods: 1) anterior pelvic tilt position with the Valsalva maneuver, 2) anterior pelvic tilt position without the Valsalva maneuver, 3) posterior pelvic tilt with the Valsalva maneuver, 4) posterior pelvic tilt without the Valsalva maneuver. The EMG activity of erector spinae was recorded during both lifting and lowering with each method. The EMG activity of each individual was normalized to EMG activity produced by muscle during maximal voluntary contraction. Two-way analysis of variance for repeated measures ($2{\times}2$) was used to analyze the effect of the two factors: 1) pelvic tilt position (anterior pelvic tilt, posterior pelvic tilt), 2) the Valsalva maneuver (with and without). Analysis was performed separately for the lifting and lowering. The results were as follows: 1) EMG activity of erector spinae was greater when the pelvis was tilted anteriorly than when the pelvis was tilted posteriorly during squat lifting and squat lowering. 2) There was no difference between EMG activity of erector spinae with the Valsalva maneuver and EMG activity of erector spinae without the Valsalva maneuver during squat lifting and squat lowering. These results suggest that the greater EMG activity of erector spinae with an anterior pelvic tilt position during squat lifting and squat lowering may ensure optimal muscular support for the spine while handling loads, but the Valsalva maneuver may have less effect on erector spinae.

• Korean Journal of Anesthesiology
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• v.71 no.6
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• pp.453-458
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• 2018

Background: Pain on injection is a limitation with propofol use. The effect of the Valsalva maneuver on pain during propofol injection has not been studied. This maneuver reduces pain through the sinoaortic baroreceptor reflex arc and by distraction. We aimed to assess the efficacy of the Valsalva maneuver in reducing pain during propofol injection. Methods: Eighty American Society of Anesthesiologists class I adult patients undergoing general anesthesia were enrolled and divided into two groups of 40 each. Group I (Valsalva) patients blew into a sphygmomanometer tube raising the mercury column up to 30 mmHg for 20 seconds, while Group II (Control) patients did not. Anesthesia was induced with 1% propofol immediately afterwards. Pain was assessed on a 10-point visual analog scale (VAS), where 0 represented no pain, and 10, the worst imaginable pain, and a 4-point withdrawal response score, where 0 represented no pain, and 3, the worst imaginable pain. Scores were presented as median (interquartile range). Results: We analyzed the data of 70 patients. The incidence of pain was significantly lower in the Valsalva than in the control group (53% vs. 78%, P = 0.029). The withdrawal response score was significantly lower in the Valsalva group (1.00 [0.00-1.00] vs. 2.00 [2.00-3.00], P < 0.001). The VAS score was significantly lower in the Valsalva group (1.00 [0.00-4.00] vs. 7.00 [6.25-8.00], P < 0.001). Conclusions: A prior Valsalva maneuver is effective in attenuating injection pain due to propofol; it is advantageous in being a non-pharmacological, safe, easy, and time-effective technique.

• Journal of Korean Physical Therapy Science
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• v.27 no.3
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• pp.75-83
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• 2020

Background: The effect of the Valsalva maneuver applied in resistance exercise has shown contradictory results. This study aims to investigate the effect of the Valsalva maneuver on resistance exercise by examining the changes that occur by applying the Valsalva maneuver during trunk flexion and extension resistance exercise in healthy adults. Design: Randomized controlled trial. Methods: 34 healthy adults were conveniently recruited. According to the with or without Valsalva maneuver, the flexion and extension of the trunk were measured and evaluated. Results: Paired t test showed that there was a statistically significant difference in maximum torque of trunk flexion in the resistance exercise with Valsalva maneuver. However, there was no statistically significant difference in trunk extension (p<.05), in the total and average work of trunk flexion and extension (p<.05). Conclusion: The results of this study in which the difference in the amount of exercise according to the application of the Valsalva maneuver was not significant, show that the practice of the Valsalva maneuver, which has a risk of injury, should be avoided in rehabilitation exercises.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.2
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• pp.129-138
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• 2013

Objectives : This study investigated the relationship between straight leg raising(SLR), valsalva test and size, position of lumbar disc herniation. Methods : We took SLR and valsalva test on 105 patients with lumbar disc herniation. According to the result of MRI findings, this study classified three groups of 105 patients with lumbar disc herniation, bulging, protrusion and extrusion. According to the position of lumbar disc herniation, 72 patients that were diagnosed protrusion and extrsuion were sorted 4 groups, lateral, lateral postero-lateral, central postero-lateral, central. The association size, position of lumbar disc herniation and SLR, valsalva test were analysed. Results : The bigger size of disc herniation, the more positive result of SLR and valsalva test, the lower angle of SLR test. There was not significant association between the position of lumbar disc herniation and the angle of SLR test. Conclusions : The SLR and valsalva test is an useful physical examination to speculate about the degree of lumbar disc herniation.

• Journal of Chest Surgery
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• v.12 no.1
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• pp.43-49
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• 1979

This is a case report of surgically treated rupture of Valsalva Sinus aneurysm combined with VSD. He has been relatively healthy until about one month before admission, when during bath, he felt abruptly palpitation, left chest pain and exertional dyspnea. These symptoms have progressed. On admission, thrill was palpable and continuous machinery murmur was audible on 2nd and 3rd intercostal space along the left sternal border. A rupture of Valsalva`s sinus aneurysm was confirmed by aortography and echocardiography but a small VSD was found by cardiotomy in open heart surgery. On 11th Sep. 1978, open heart surgery was performed. Valsalva`s sinus aneurysm came out from right coronary aortic sinus and ruptured into the right ventricle. It sized 1.2X1.5X1.5 cm. Ruptured opening was noted on apex of aneurysm [0.8X0.8cm], VSD [1. 0X0. 3cm in size] was just below the aortic annulus. The aneurysmal sac was removed on neck. After that, VSD and aneurysmal orifice were closed together with interrupted mattress sutures on same plane. The postoperative course was uneventful and discharged three weeks after open heart surgery.

• Journal of Chest Surgery
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• v.27 no.7
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• pp.621-623
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• 1994

Over the past 3.5 years, 5 cases with ruptured sinus of Valsalva were operated upon at Asan Medical Center. Four patients were congenital and 1 traumatic. Coexistent lesions included 2 subarterial VSD, 3 AR requiring procedures [2 AVR, 1 valvoplasty], 2 subaortic membranes, 1 PDA,and 1 bicuspid AV. The communication is noncoronary sinus to RA in I and fight Coronary sinus to RV in the other 4 patients. The ~rstula was repaired through the aorta whenever possible and reinforced through the right sided chamber. There are no surgical mortality and, no recurrence of rupture yet.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.687-692
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• 1989

Aneurysm of the sinus of Valsalva is an uncommon cardiac anomaly, usually congenital in origin, which may occur as an isolated defect or in conjunction with other cardiac malformation. This report is a case of a ruptured sinus of Valsalva aneurysm with ventricular septal defect in a 18-year-old female patient who complained progressive exertional dyspnea. She underwent operative management using total cardiopulmonary bypass. The fistula originated from the right coronary sinus and ruptured into the right ventricle and coexistent lesion was supracristal ventricular septal defect. The repair was done through aortic and right ventricular approach. The ruptured sinus of Valsalva was closed with pledget suture and the ventricular septal defect was closed with patch. The postoperative result was good.

• Journal of Chest Surgery
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• v.15 no.1
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• pp.124-128
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• 1982

Here, we present a case of ruptured sinus Valsalva aneurysm with fistulous communication between the right coronary aortic sinus and the right ventricle in 8 year old boy. Ruptured sinus Valsalva aneurysm is rare. And several reports are describing its pathophysiologic features, clinical findings and management. This patient was asymptomatic and the physical examination revealed palpable thrill and Grade III pansystolic murmur at the 3rd and 4th intercostal space along the left sternal border. There was an oxygen step up from right atrium into right ventricle on the cardiac catheterization reports. On 15th July 1981, an open heart surgery was performed and we found ruptured right coronary sinus Valsalva aneurysm into the right ventricle, which was managed successfully by doing direct pledget sutures. The postoperative course was uneventful.

• Journal of Chest Surgery
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• v.44 no.3
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• pp.240-242
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• 2011

We experienced a case of ruptured aneurysm of the sinus of Valsalva, and this resulted in simultaneous aortic and tricuspid valve endocarditis through a shunt. The echocardiography showed a ruptured sinus of Valsalva aneurysm to the right atrium with a shunt. The aortic non-coronary cusp was fibro-thickened with vegetation. Vegetations of the septal leaflet and the anterior leaflet of the tricuspid valve were also found. The blood culture grew Enterococcus garllinarum. We replaced both tricuspid and aortic valve with successful surgical result.