1. Abnormal Valsalva Maneuver Is Not Always a Sign of Congestive Heart Failure 
Satish R. Raj, MD, MSCI, David Robertson, MD, Italo Biaggioni, MD, André Diedrich, MD, PhD 
The American Journal of Medicine 
Volume 120, Issue 6, Pages e15-e16 (June 2007)
DOI: /j.amjmed
Copyright © 2007 Elsevier Inc. Terms and Conditions

2. Figure 1
Absent sympathetically mediated vasoconstriction in autonomic nervous system failure. The heart rate, blood pressure, and generated Valsalva pressure are shown top to bottom. The blood pressure decreases throughout the Valsalva maneuver without late recovery, and blood pressure after release of Valsalva does not recover back to the baseline blood pressure, let alone “overshoot” the baseline blood pressure.
The American Journal of Medicine  , e15-e16DOI: ( /j.amjmed )
Copyright © 2007 Elsevier Inc. Terms and Conditions

3. Figure 2
Square wave pattern Valsalva response in a healthy volunteer. The blood pressure paradoxically increases with Valsalva and stays elevated until the release of Valsalva.
The American Journal of Medicine  , e15-e16DOI: ( /j.amjmed )
Copyright © 2007 Elsevier Inc. Terms and Conditions