Table 2.

Comparisons between TENSE and other provincial maneuvers.

Commonly used provocative maneuvers	PFO diagnostic sensitivity	Patient cooperation required	Difficulty completing effective action	Can be combined with Valsalva	TEE sectional image Stability
Valsalva	—	Yes	Hard	—	Bad
Forced expiratory	—	Yes	Hard	—	Bad
Deep inspiration	—	Yes	Hard	—	Bad
Cough	—	Yes	Hard	No	Bad
Müller (modified)	—	Yes	Hard	Yes	Bad
Abdominal compression	Better than ineffective Valsalva	No	—	Yes	Bad
IVC compression	Better than ineffective Valsalva	No	—	Yes	Good
TENSE	Better than ineffective Valsalva	Yes	Easy	Yes	Good