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Old 09-28-2009
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Heart HepatoJugular Reflux?

Any idea what is the hepatojugular reflux?
Does it have anything to do with the Kussmaul's sign
I've seen a question about it in one of the banks but they gave no explanation.
Any help would be appreciated.
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Old 09-28-2009
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Recently it has been renamed into abdominojugular test or reflux.

Basically, when you press on the right upper quadrant (the liver) you are compressing the liver with its sinusoids and pushing blood up into the right atrium which is reflected by an elevated JVP.

The test is difficult to perform and interpret but when it's done in the right way it highly corresponds to the capillary wedge pressure as it reflects how far you have congestion in the systemic circulation.

In Kussmaul's sign you also have elevated JVP, but this time it happens during inspiration and usually associated with constrictive pericarditis, so the mechanism here is improper filling of the right atrium rather than too much filling of the right atrium.

Last edited by Sabio; 12-05-2009 at 02:46 PM.
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Old 12-04-2009
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Thank you very much for the great answer
I just want to add that Kussmaul's sign is seen in constrictive pericarditis only and not in cardiac temponade
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Old 12-05-2009
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I totally agree..
I must add that an absent hepatojugular reflex is a sign of IVC obstruction above the level of the liver.
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Old 12-21-2009
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Quote:
I just want to add that Kussmaul's sign is seen in constrictive pericarditis only and not in cardiac temponade
And why is that? In both conditions, there is decreased ventricular filling and decreased ability of the atria to accomodate the increase in venous return!

Wikipedia Link
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Old 12-21-2009
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Quote:
Originally Posted by Hadi View Post
And why is that? In both conditions, there is decreased ventricular filling and decreased ability of the atria to accomodate the increase in venous return!

Wikipedia Link
The hepatojugular reflex is negative in cardiac temponade and I don't know why
References:
The American Journal of Medicine
read the last sentence in the abstract

also here
clinicalexam.com
read the last point in Kussmaul's sign paragraph

Wikipedia articles often contain errors as they are written by non-expert people, it can be written by anybody.
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