Why do I have trigeminal pulse after Valsalva maneuver?

Hi,

Welcome to icliniq.com.

I have carefully reviewed your case and understand that you are worried about your heartbeats and pulse after doing the Valsalva maneuver.

The trigeminal pulse is defined as the one with a pause after every third heartbeat. It is usually due to the underlying process called premature ventricular contractions (PVCs), and in older adults, it is common. It warrants further investigations, although it is quite regular in occurrence and is prevalent in a large group of people at an older age.

It feels like our heart is skipping a beat, and sometimes there is a tiny early beat followed by a delay that may go longer, giving the feeling of a pause. We can see a bigeminal or a trigeminal PVC in patients. In bigeminal PVC, there is one abnormal PVC cycle and one normal one. In trigeminal, there is PVC in combination with two normal cycles of heartbeats (one skipped beat with two normal beats of the heart).

Less serious causes may include certain medications, caffeine, life stress, alcohol use, and remaining attentive for long periods with a lack of sleep in between. Proper sleep is necessary for life to go on in a normal rhythm. Seriously alarming causes may include heart rhythm diseases, diseases of the valves of the heart, and coronary artery disease.

My final impression is, please make an appointment with a cardiologist for proper evaluation and diagnosis if there is any underlying disease of the heart going on. Management depends mainly on the diagnosis.

Hope it helps.

Please feel free to contact me if you need further assistance. I would be happy to help.

Regards.

Hi,

Welcome back to icliniq.com.

I can realize that you are concerned more about the underlying reasons behind the changes in heartbeats and pulse with the Valsalva maneuver. Valsalva is used to see if there is anything bad going on with the heart regarding its pumping function (electrical and mechanical processes that lead to synchronous pumping of the heart).

Valsalva increases load on the heart, and we see how the heart behaves on this increased afterload. Valsalva increases the pressure in the chest, which affects the heart, too. It reduces the filling of the heart and changes blood pressure (rises and then falls). Heart rate is also affected, and we see how the heart takes its dynamics back to normal. Usually, we use Valsalva to differentiate heart disease, such as murmurs of the heart.

Pulmonary sarcoidosis may affect lung function depending on the advancement of the disease. This may affect Valsalva to some extent, too. But that is compensated for and ruled out when we go for further heart evaluation.

If your cardiologist finds something on investigations, it can be evaluated accordingly. Otherwise, it can fall under the category of less serious causes aforementioned. Lifestyle changes can then be helpful.

Hope this helps. Please feel free if you need further assistance. I am here to help.

Regards.