CTICasesValsalva-Induced Abdominal Aortic Collapse
Imaging findings
Contrast-enhanced abdominal CT obtained during a forceful Valsalva maneuver demonstrates severe, slit-like collapse of the abdominal aorta and iliac arteries at the level of the diaphragmatic hiatus and below. A repeat contrast-enhanced CT scan performed under normal inspiratory conditions shows a completely normal-caliber abdominal aorta with only minimal atherosclerotic plaque.
Key takeaways
Forceful Valsalva maneuvers can generate massive intra-abdominal pressures that can cause transient, severe collapse of the abdominal aorta and its major branches, particularly in individuals capable of generating high muscular tension. This rare, transient phenomenon must be distinguished from organic aortic stenosis, hypovolemia, or dissection. Repeat imaging with normal respiration is key to confirming a normal underlying vessel.
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