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Exercise vs Self-Directed Valsalva and Goal-Directed Valsalva
The figure compares the efficacy of exercise, SDV, and GDV and provides an example of a patient with HCM and symptoms with exertion. At rest, his peak LVOT gradient was only 13 mm Hg and rose to 70 mm Hg with GDV. With exercise, the LVOT gradient rose to near 120 mm Hg consistent with severe obstruction. Abbreviations as in Figures 1 and 3.
