Does the Valsalva maneuver exacerbate left atrial compression in patients with large hiatal hernia?
Conditions associated with decreased preload and increased intra-abdominal pressure, such as the Valsalva maneuver, can exacerbate the cardiac compressive effects of large hiatal hernias.
VM can markedly exacerbate LA compression in HH patients; however, LV filling is relatively less affected possibly due to augmented early diastolic filling. Conditions associated with decreased preload and increased intra-abdominal pressure may exacerbate the cardiac effects of large HH.
Naoum et al. (Tue,) studied this question.