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Valsalva Maneuver: Uses and Warnings

Medically reviewed by John Paul Abrina, MD · Oncology · Davao Doctors Hospital

Written by Nikita Bhalla · Updated Aug 22, 2022

    Valsalva Maneuver: Uses and Warnings

    The Valsalva maneuver is a breathing technique that is simple and has multiple health benefits. The breathing technique has scientifically proven benefits in medicine. The breathing technique, when performed in a correct way, helps to normalize the heart rate and blood pressure.

    It is usually recommended to individuals who have issues like sudden changes in the heart rate or who experience airplane ear. The exercise can be performed at any time anywhere. To do the exercise you just need to fill your mouth with air and tightly close it. Now block your nose using your fingers and breathe out. This simple exercise helps to regulate your heartbeats.

    The Valsalva maneuver breathing technique is named after Antonio Maria Valsalva, an Italian physician from the 17th century. Valsalva’s major interest was the human ear. He defined the Eustachian tube and the maneuver to check the openness and its usage to release fluid from the middle ear.

    Uses of Valsalva maneuver

    The Valsalva maneuver has multiple benefits. Your doctor may recommend you practice this breathing technique majorly for two reasons – to regulate heart rate and blood pressure.

    valsalva maneuver

    To treat abnormal heart rate

    Valsalva maneuver is usually recommended for patients with supraventricular tachycardia (SVT). It is a broad term used to define conditions in which you have an abnormal heart rate. The common symptom of SVT is heart palpitations.

    Not all patients with SVT experience symptoms. Practicing Valsalva maneuver when you experience the symptoms helps to restore normal heart rate. You may need to repeat the process two to three times to show effective results.

    To treat clogged ears

    The breathing technique is helpful to treat a blockage in the Eustachian tube in your middle ear. It is also helpful to treat airplane ear.

    Airplane ear is a condition in which you experience pain or congestion in the ears, during the take-offs and landings of airplanes. This occurs because of the sudden change in altitude and air pressure. Valsalva maneuver helps to relieve the pain and congestion by applying pressure via Eustachian tube.

    To detect cervical spine injury

    The breathing technique is also helpful to detect if you have a cervical spine injury. Practicing the exercise gradually puts pressure on the spine. If you have any injury you may experience an increase in the pain in the injured area.

    While scuba diving

    This is a non-medical use of the Valsalva maneuver. The breathing technique is used by scuba divers as it helps to open the Eustachian tube with gentle pressure and balance the pressure in the middle ear.

    While lifting heavy weights

    Weightlifters use the technique as they lift heavy weights. The technique helps to provide energy and balance in the chest.

    How to perform Valsalva maneuver

    Performing the Valsalva maneuver is simple and just requires you to follow these four simple steps.

    • Sit in a comfortable position and relax.
    • Take a deep breath, fill your mouth with air, and close your mouth.
    • Now shut your nose using your fingers.
    • Try to breathe out, apply some pressure.

    Hold the maneuver for a minimum of 15 seconds.

    If practicing the exercise is not effective, take a break of two minutes and repeat.

    Phases of Valsalva maneuver

    There are four phases of the Valsalva maneuver. They are:

    Phase 1 – In the first phase, as you breathe out with closed airways there is an increase in the blood pressure. There is no effect on the heart rate. This is the beginning of the breathing technique, when you breathe out using closed airways it increases pressure on the chest. This pressure forces the blood out of the respiratory system into the left atrium.

    Phase 2 – In the second phase, there is a drop in the amount of blood pumped by your heart. This drop occurs because of the excess pressure on the chest cavity that makes it difficult for the blood to return to the chest from the other parts of the body including the heart. To balance it out, your blood vessels narrow and this results in an increase in the blood pressure. The increase in blood pressure is constant until the end of the breathing technique.

    Phase 3 – Phase third occurs when you resume your normal breathing. In this phase, your blood pressure falls for a brief period.

    Phase 4 – In the fourth phase, the blood flow and heart rate return to normal.


    • The one major side effect of practicing the Valsalva maneuver is it can cause hypotension. Since while performing the exercise you may experience a severe drop in the blood pressure it can make you unconscious.
    • Even though Valsalva maneuver is said to treat abnormal heart rate, it should not be used to treat all types of heart ailments. It may cause some serious side effects if not practiced properly.
    • Avoid practicing the technique if you have hypertension. The exercise may increase your risk of heart attack or stroke.
    • Avoid practicing the breathing technique if you have any issues with your eyes or have had any eye surgery in the past. The exercise may put stress on the eyes.
    • Seek medical help if you are experiencing supraventricular tachycardia (SVT) and practicing the breathing technique does not provide you relief. Even in serious cases, when you experience difficulty in breathing or severe chest pain, it is advised to seek medical help immediately.
    • Practice the exercise with caution if you have a damaged eardrum or a history of ear ailments. Since the exercise requires breathing out with pressure, it can make your condition worse.
    • Even though the Valsalva maneuver has proven benefits, it should be first practiced under a healthcare professional’s guidance. If you know the right technique to perform the exercise, it would be helpful for you to treat the abnormal heart rate in a safe manner.
    • If you have a history of abnormal heart rate but your doctor has never recommended the exercise, ask your doctor if it is suitable for you. Also, ask if there are any potential side effects you may experience.
    • If you have any existing medical conditions, talk to your doctor before performing the breathing exercise.


    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Medically reviewed by

    John Paul Abrina, MD

    Oncology · Davao Doctors Hospital

    Written by Nikita Bhalla · Updated Aug 22, 2022

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