Valsalva manoeuvre

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This is forceful expiration against a closed glottis.

The patient is asked to hold his nose with his fingers, close his mouth and to breath out maximally (like straining at passing stool).

The Valsalva manoeuvre has effects on various murmurs:

  • mitral valve prolapse - the systolic murmur becomes elongated
  • aortic stenosis - the systolic ejection murmur becomes softer
  • mitral regurgitation - the systolic murmur becomes softer
  • hypertrophic cardiomyopathy - the late systolic murmur becomes louder

Last reviewed 01/2018

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