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Valsalva's Maneuver for Evaluating the Integrity of Baroreceptor Relfex Arc

Paolo Palatini, MD; Achille C. Pessina, MD, PhD
Arch Intern Med. 1987;147(3):614-615. doi:10.1001/archinte.1987.00370030211048.
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To the Editor.  —Valsalva's maneuver is widely regarded as a reliable method to evaluate the overall integrity of the baroreceptor reflex arc.1-3 The results we obtained in a 37-year-old woman, who underwent a glomectomy bilaterally because of the presence of carotid body tumors, do not seem to support this belief.The bilateral carotid sinus denervation produced by the operation caused marked tachycardia (120 to 170 beats per minute), sustained hypertension (170/105 mm Hg on the average) and, understandably, the loss of an adequate blood pressure control while our patient was standing. Other authors have observed similar findings in patients who have undergone glomectomy bilaterally.4When the patient assumed an upright posture and tilted her head, intra-arterial blood pressure monitoring, performed using the Oxford method5 17 months after her glomectomy, showed a sharp fall in blood pressure, followed by wide cyclic blood pressure variations (195/125 to 130/90 mm


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