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* Valsalva Maneuver/Squatting
  pinx121 - 11/13/06 04:29
  Hey guys, can anyone please explain to me what effects the Valsalva maneuver has on venous return? What about Squatting? If a patient has Aortic Stenosis....if u decrease the venous return, wouldnt that make the murmur decrease? So confused!!!!  
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* Re:Valsalva Maneuver/Squatting
  step123cs - 11/13/06 04:52
  valsalva maneuver is exhalation against closed glottis(closed mouth)--- increase the intrathoracic pressure ---so decreases preload and ------ decreases venous return to the heart..... therefore VM reduces the mumur in AS

squattin--- veins inthe legs r squeezed up---- so increases the venous return to the heart
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* Re:Valsalva Maneuver/Squatting
  mona - 11/13/06 04:54
  valsalva------->dec. venous return
squatting------>inc. venous return (by squeezing vessels)

now wats the effect of dec. VR on AS ?
dec. VR----->dec. blood in lt. ventricle--------> dec blood has to b pumped against smaller valve-----> dec. murmur ( think in this way....wats the treatment of AS...... dec. VR . so dec. VR improves codition in AS & dec. murmur)

-- dec. in VR dec. murmur in AS,MS,AR,MR ----------------inc. in HOCM
-- inc. in VR inc. murmur in AS,MS,AR,MR ----------------dec. in HOCM

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* Re:Valsalva Maneuver/Squatting
  pinx121 - 11/13/06 05:02
  Thanks for responding guys! One other question for anyone out there... Kaplan says.. that squatting also decreases the murmur of AS! That cant be true right?? Squatting increases venous return...if u have increase return..means you have increase flow across the stenotic valve hence increase in the murmur?? Am i correct?  
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* Re:Valsalva Maneuver/Squatting
  pinx121 - 11/13/06 05:04
  Sorry guys one last question.....I just want to make sure i have everything correct. Standing causes a decrease in venous return? or increase? It causes pooling of blood in the venous system so decrease in preload?  
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* Re:Valsalva Maneuver/Squatting
  step123cs - 11/13/06 05:05
  ur welcome... pinx ur rite ... squattin and leg raisin too increases the venous return to the heart.... evn conrad said the same thing ... he compared it to like squeezing of a tooth paste!!!  
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* Re:Valsalva Maneuver/Squatting
  step123cs - 11/13/06 05:09
  ya standin puts less blood to the heart as blood pools in to the legs----- therefore 0 pressure in the rt atrium.... so murmur decreased..... jus like valsalva
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* Re:Valsalva Maneuver/Squatting
  pinx121 - 11/13/06 05:10
  :) thanks Step123cs  
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* Re:Valsalva Maneuver/Squatting
  step123cs - 11/13/06 05:18
  ur welcome pinx121  
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