The Valsalva Deep Dive

Mastering the Valsalva in HOCM

Most sonographers know to do a Valsalva during a HOCM study. Far fewer know exactly what they are waiting for, how to set up their Doppler to capture it cleanly, or what to do when the patient cannot cooperate or the heart moves mid-maneuver.

In this lesson, you will learn the full hemodynamic story of the Valsalva maneuver, why the release phase is where the gradient lives, how to use PW to locate your obstruction before committing to CW, and the practical tricks that separate a clean, reportable gradient from a waveform you cannot measure.

The 6.88 m/s peak velocity in the case below did not come from luck. It came from setup.