Valsalva Test Experience

[jesse1919]

I've seen many posts about how bad the tilt test is but for me the tilt wasn't too terrible but Valsalva was bad. I answered 5. Everything moved violently in an infinity symbol pattern, blacked out, tech asked if I passed out, I said yes and she scurried out to get somebody else to help watch me (?) I had to lay there for a few minutes until I felt okay to stand. I haven't fainted with POTS except for Valsalva.

Edited August 23, 2008 by flop

[Ernie]

Hi,

Everytime I do a Valsalva I faint. I did 3 at Vanderbilt and even Bonnie Black and Dr Robertson freaked out!

[Michelle F.]

Does anyone know of a good link to describe this test? It sounds like a pro-longed blowing into a tube. I can say that everytime I have to take a deep breath for doctor's to listen to my lungs, I get even more light-headed. After two or three, even with some time between them, I am real close to fainting.

[delphicdragon]

Anyone have an abnormal result with the deep breathing part of the tilt table test? My valsalva test was normal but my deep breathing test was not. No one has ever told me what that means.

Also anyone have to have oxygen during the tilt? I was told I had a profound "air hunger" and therefore was put on Oxygen. Didn't matter, heart rate still went up 30 bpm immediately upon standing. I figure that needing Oxygen should negate the results of the tilt as I'm not on oxygen all the time now.

Just curious.

Sara

[ajw4790]

For the Valsalva Test I think there are a few variations. You may want to specify what test you are looking for info on. I think I did more or less have this test but it was not the same as what you described, so I wasn't sure if my reaction would be equal to someone who had the testing done differently.

[BlackCat]

Yeah, the Valsalva *****. No wonder I used to get so tired playing the clarinet in the 11th grade. My heart would pound and swing on me and I couldn't keep up with all the blowing into that instrument.

[Tammy]

I've never heard of this test, what type of doctor do you go to for it? My cardio has done a TTT but he's never mentioned this one. I can't blow up a balloon or even a beach ball, and singing more than a minute of a song is too much, so would guess I would do very poorly on it... however, is there a point to having this test done - can they do anything for a person so they are able to blow up a balloon, sing, etc.????

[Angelika_23]

This test really stunk. I couldn't get up for almost an hour afterward, and even then I was shaking so hard I couldn't even walk by myself. I voted this worse than the tilt because my ttt was improperly done (on meds with my stocking on...) so my ttt wasn't too bad.

[mkoven]

I think valsalva tests for a neurological reflex. I was told, for example, that my valsalva was normal, but my tilt was not, which led them to conclude that my problem is not neurological but vascular--i.e. my blood pools because of bad vessels, not anything in my brain. I was also told that normals can get a little dizzy on valsalva.

[jesse1919]

Wow very interesting.

Description of Mayo tilt table tests:

They did the tilt test first, then the deep breathing test, then Valsalva. You're laying down on the tilt table for deep breathing and Valsalva. The have ECG leads, breathing strain gauge around your chest and a pulse/ 02/ pressure sensor on you finger for all 3 tests. Deep breathing- they have a metronome with a light bar that you try to match your breathing rate to. It's cadence is relatively slow so you naturally breath deeply to keep your oxygen supply up. For me that was easy, results were normal. Valsavla- they have an old pneumatic blood pressure gauge, they take the cuff off and put a mouthpiece on. You're told to blow for I think 10 seconds and maintain the needle at a certain pressure (30 mmHg ?). Wikipedia has a description of what they analyze. I didn't know there was a different way to do the test ajw. Normals can get a little light-headed doing this too. You certainly shouldn't pass out especially because you're laying down.

[flop]

Different hospitals do the valsalva test differently. Essentially the valsalva manoeuvre is forced expiration (breathing out) either with the throat closed (needs practice to do this correctly) or by blowing out against something (just like blowing up a balloon). I had mine done as part of one of my tilt tests in London, whilst tilted upright I had to blow into the tube of a blood pressure gauge and keep the needle pointing at 40mmHg for as long as I could, this was repeated 3 times.

The point of doing valsalva is that it causes a big increase of pressure within the chest, this changes how the blood flows to and from the heart. There is a "normal" pattern of what should happen to your BP and HR at different points during the test. The doctors can compare your results with what should have happened to see if either a cardiac or neurological problem is occuring. There is quite a good explanation on wikipedia if you search for "Valsalva".

I felt dizzy and lightheaded during the test but I didn't actually faint (none of the tests I have had done have actually caused me to faint despite the fact that I have fainted a lot in everyday life!). I don't yet know the results of my tests so I don't know if my dizziness was just a normal reaction.

Flop

[flop]

Tammy - as far as I know there isn't any specific treatment that can enable you to blow up balloons or sing. The test is done sometimes to help with diagnosing the cause of dizziness.

[flop]

Sara - interesting that you needed oxygen during the testing. I guess they were giving you oxygen so that your body wasn't hyperventilating during the test (having an abnormal breathing pattern can mess up the tilt results). I think that the oxygen normalising your breathing would let them know that your HR and BP reactions were because of the TTT and not because of the air hunger, so in a way it shows that the HR increase of 30/min is a true reaction and not one caused by you breathing too fast.

Flop