The Valsalva maneuver is a particular way of breathing that increases pressure in the chest. It causes various effects in the body, including changes in the heart rate and blood pressure.

The physician Antonio Maria Valsalva first described the technique in the 1700s as a method to clear pus from the ears.

People may perform the maneuver regularly without knowing it. For example, they may use it when they push to initiate a bowel movement.

However, this technique can also be beneficial when people use it intentionally, as it can regulate heart rhythms and help the ears to pop.

To do the Valsalva maneuver, use the following steps:

  • Inhale deeply and hold your breath.
  • Imagine that your chest and stomach muscles are very tight and bear down as if straining to initiate a bowel movement.
  • Hold this position for a short time, usually about 10 seconds.
  • Breathe out forcibly to release your breath rapidly.
  • Resume normal breathing.

An alternative method involves lying down and blowing into an empty syringe for 15 seconds.

The Valsalva maneuver creates numerous effects in the body because it increases pressure in the chest, known as intrathoracic pressure.

Research divides the effects of this maneuver into the following four phases:

  • Phase one: Blood pressure temporarily rises as some blood enters the aorta, a major artery that pumps oxygen-rich blood through the body.
  • Phase two: As intrathoracic pressure reduces, blood pressure falls. A sensor in the carotid artery, called the baroreceptor, detects the increased blood pressure, causing blood vessels to narrow and the heartbeat to speed up.
  • Phase three: Pressure releases, causing a dip in blood pressure.
  • Phase four: Typical blood flow to the heart resumes, causing blood pressure to increase and overshoot its baseline level. This leads to a slower heart rate and the return of blood pressure to the baseline.

The Valsalva maneuver reduces cardiac output, which is the amount of blood that the heart puts out with every beat. The individual may feel lightheaded or dizzy as a result.

Doctors may use the Valsalva maneuver to treat people with supraventricular tachycardia (SVT). SVT is a rapid heart rate that is typically over 100 beats per minute at rest in adults. It can cause symptoms including heart palpitations, chest pain, and shortness of breath.

A heart rate of this speed can be dangerous because the heart cannot pump enough blood when it beats so quickly.

SVT often requires emergency treatment. Once emergency responders have identified a person’s heart rhythm and determined that their blood pressure is stable, they may demonstrate how to perform the Valsalva maneuver.

According to a 2024 review of 19 studies with 2,527 participants, the modified Valsalva maneuver can significantly improve the success of cardioversion in people with paroxysmal SVT.

The modified version of the Valsalva maneuver involves the person being in a semi-recumbent position and, immediately after the standard maneuver, raising the legs to a 45-degree angle.

Key terms explained

  • Cardioversion: This is a medical treatment that uses electric shocks to restore a typical heart rhythm.
  • Paroxysmal: This refers to a sudden onset or intensification of symptoms.
  • Semi-recumbent: A position that is halfway between lying down and sitting upright.

Other potential uses

Other potential uses of the Valsalva maneuver include:

  • clearing the ears when scuba diving or a change in altitude increases pressure
  • increasing colonic pressure to induce a bowel movement

Weightlifters also tend to perform the Valsalva maneuver when they lift heavy weights. Some may try this technique deliberately, while others will not realize that they are using it.

It is a common belief that using the Valsalva maneuver when lifting heavy weights can provide momentum and trunk stabilization.

Doctors may use it as a tool to:

Research suggests that the Valsalva maneuver is relatively safe, with a rare risk of adverse effects. However, doctors may not recommend the maneuver for people with the following health conditions:

The primary side effect of the Valsalva maneuver is hypotension, which is a sudden, persistent decrease in blood pressure.

People performing the maneuver may also feel lightheaded or faint. In some cases, people may experience chest pain or an irregular heart rate.

The Valsalva maneuver can help reduce rapid heart rhythms for some people. It can also help people to pop their ears, lift weights, or have a bowel movement.

While the Valsalva maneuver has some potential side effects, such as lightheadedness, it is a noninvasive alternative to other treatments, such as medication or electric shocks.