Kussmaul's Sign - Differential Diagnosis
Typically the JVP decreases with inspiration as the negative intrathoracic pressure "sucks in" blood from vena cava. When there is a lack of decrease or increase in JVP with inspiration, this finding is called Kussmaul's sign. Kussmaul's sign reflects conditions where there is RV dysfunction, impaired RV filling and increased RA pressure.
Kussmaul's sign is classically associated with constrictive pericarditis. Other conditions where we may see a positive Kussmaul's sign include restrictive cardiomyopathy, RV predominant infarction, massive PE, tricuspid stenosis, and severe TR.
- Dr. Bibin Varghese @varghes_bibin
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