 Cardiac arrest<ref name="pmid27716918"></ref> and other cardiovascular complications<ref name="pmid27151226"></ref> can in rare cases occur due to attempting to defecate using the valsalva maneuver.Valsalva retinopathy is another pathological syndrome associated with the Valsalva maneuver.<ref></ref><ref name="pmid19747224"></ref> Thoracic blood pressure rises and as a reflex response the amount of blood pumped by the heart decreases.Death has been known to occur in cases where defecation causes the blood pressure to rise enough to cause the rupture of an aneurysm or to dislodge blood clots (see thrombosis).