JVP In Kussmaul's sign

 Q: In Kussmaul's sign - the Jugular Venous Pressure (JVP) _____________ during inspiration? (select one) 

 A) decreases 

 B) increases 

Answer: B 

 In a healthy adult patient, the height of JVP should declines with inspiration i.e., towards the clavicle. If it fails to occur or on the contrary rises up in the neck, it is called Kussmaul's sign. Kussmaul’s sign is a classical presentation of constrictive or effusive pericarditis or restrictive cardiomyopathy. 

Other conditions that may be associated with it are Right Ventricular (RV) infarction, RV dysfunction, massive pulmonary embolism (PE), partial obstruction of the venae cavae, right atrial and RV tumors, severe tricuspid regurgitation, tricuspid stenosis, and rarely cardiac tamponade.

#cardiology

#physical-exam

References:

1. Meyer TE, Sareli P, Marcus RH, et al. Mechanism underlying Kussmaul's sign in chronic constrictive pericarditis. Am J Cardiol 1989; 64:1069. 

2. Nadir AM, Beadle R, Lim HS. Kussmaul physiology in patients with heart failure. Circ Heart Fail 2014; 7:440. 

3.  Dell'Italia LJ, Starling MR, O'Rourke RA. Physical examination for exclusion of hemodynamically important right ventricular infarction. Ann Intern Med 1983; 99:608.