Kumar S, et al. - The clinical effectiveness of the goal-directed Valsalva maneuver (GDV) in hypertrophic cardiomyopathy (HCM) as a method to provoke left ventricular outflow tract obstruction was determined. GDV as an objective, practical, and effective physiologic method of provoking left ventricular outflow tract obstruction was identified. GDV can lead to a significant alteration in patient management via reclassifying disease severity, and its incorporation in the routine clinical evaluation of patients with HCM is recommended.