Hepatojugular reflux

Q: Hepatojugular reflux should be performed with? (select one)

A) mouth open

B) mouth close

Answer: A

The hepatojugular reflux can be a useful test in patients with right-sided heart failure. This test should be performed while the patient is lying down with the upper body at a 45-degree angle from the horizontal plane. The patient keeps the mouth open and breathes normally to prevent Valsalva's maneuver, which can give a false-positive test. Moderate pressure is then applied over the middle of the abdomen for 30 to 60 seconds. Hepatojugular reflux occurs if the height of the neck veins increases by at least 3 cm and the increase is maintained throughout the compression period. Transient elevation in JVP may be normal.

#physical exam

#cardiology

Reference:

Vaidya Y, Bhatti H, Dhamoon AS. Hepatojugular Reflux. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30252353.