ISSN 1016-5169 | E-ISSN 1308-4488
Effects of Various Maneuvers on the Right and Left Atrial Pressures [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2002; 30(5): 286-290

Effects of Various Maneuvers on the Right and Left Atrial Pressures

Şevket GÖRGÜLÜ1, Abdurrahman EKSİK1, Mehmet EREN1, Seden ÇELİK1, Bahadır DAĞDEVİREN1, Tayfun GÜROL1, Bülent UZUNLAR1, Hüseyin UYAREL1, Tuna TEZEL1

This study aims to determine the most effective maneuver, increasing pressure gradient between the right and left atrium, using the simultaneous right and left atrial pressure records. Thirty-two coronary care unit patients, in whom a Swan-Ganz catheter was inserted because of acute left ventricular dysfunction, hypotension, sinus tachycardia with unknown cause, were included in this study. The basal values of right atrium (RA) pressure and pulmonary capillary wedge pressure (PCWP) were recorded. Patients were trained with several trials to perform breath holding, successive three strong coughs, Valsalva maneuver, 20° head-down, respectively. In the end of these maneuvers, the highest RA pressure and PCWP were recorded simultaneously.
All maneuvers caused an increase in right atrial pressure. The highest mean RA pressure was obtained by means of the Valsalva maneuver (7.6±5 versus 20.4±7.6 mmHg before and after Valsalva, respectively; p<0.001). PCWP (18.8±5.9 mmHg) increased only with coughing (21.2±6.7 mmHg, p<0.01) and 20° head-down maneuver (20±5.7 mmHg, p<0.05). The highest increase in pressure gradient between mean RA pressure and PCWP was observed during the Valsalva maneuver (-11±6.6 versus 2.3±5.9 mmHg, p<0.001). The lowest increase was obtained in 20° head-down maneuver (-11±6.6 versus -8.5±5.8 mmHg, p<0.001).
The Valsalva maneuver appears to be the most effective maneuver causing increase in the pressure gradient between the right and left atrium.

How to cite this article
Şevket GÖRGÜLÜ, Abdurrahman EKSİK, Mehmet EREN, Seden ÇELİK, Bahadır DAĞDEVİREN, Tayfun GÜROL, Bülent UZUNLAR, Hüseyin UYAREL, Tuna TEZEL. Effects of Various Maneuvers on the Right and Left Atrial Pressures. Turk Kardiyol Dern Ars. 2002; 30(5): 286-290
Manuscript Language: Turkish

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