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Modified Valsalva manoeuvre in pre-hospital care - a case report

Publication at First Faculty of Medicine, Third Faculty of Medicine |
2020

Abstract

The article describes the case of a young woman with narrow complex tachycardia, in whom non-pharmacological cardioversion - the Valsalva manoeuvre (VM) - was used. Studies confirm that vagal manoeuvres are a generally recommended first-choice approach to reversing supraventricular tachyarrhythmia not only in pre-hospital care and that, for paroxysmal supraventricular tachycardia, treatment with modified VM is significantly more effective than the standard VM and is virtually the most effective of all vagal manoeuvres.

In the standard VM the patient exhales forcefully against a closed glottis. In the modified VM, the patient exhales against resistance (most commonly a syringe plunger).

In our case, the normalisation of the rhythm in supraventricular tachycardia (180 pulses/min) was used successfully in a young woman, who recovered sinus rhythm.