Kussmaul's sign
| Kussmaul's sign | |
|---|---|
| Specialty | Cardiology |
Kussmaul's sign is a paradoxical rise in jugular venous pressure (JVP) on inspiration, or a failure in the appropriate fall of the JVP with inspiration. It can be seen in some forms of heart disease and is usually indicative of limited right ventricular filling due to right heart dysfunction.
Pathophysiology
[edit | edit source]Ordinarily the JVP falls with inspiration due to reduced pressure in the expanding thoracic cavity and the increased volume afforded to right ventricular expansion during diastole. Kussmaul sign suggests impaired filling of the right ventricle due to a poorly compliant myocardium or pericardium. This impaired filling causes the increased blood flow to back up into the venous system, causing the jugular vein distention (JVD) and is seen clinically in the internal jugular veins becoming more readily visible.[citation needed]
Causes
[edit | edit source]The differential diagnoses of Kussmaul's sign includes constrictive pericarditis, restrictive cardiomyopathy, pericardial effusion, and severe right-sided heart failure.[citation needed]
With cardiac tamponade, jugular veins are distended and typically show a prominent x descent and an absent y descent as opposed to patients with constrictive pericarditis (prominent x and y descent); see Beck's triad.[1]
Other possible causes of Kussmaul's sign include:[2][citation needed]
- Right ventricular infarction - low ventricular compliance
- Cardiac tumours
- Tricuspid stenosis
- Pulmonary embolism
History
[edit | edit source]Kussmaul's sign is named after the German doctor who first described it, Adolph Kussmaul (1822–1902).[3][4] He is also credited with describing Kussmaul breathing.[5]
See also
[edit | edit source]References
[edit | edit source]- ^ Disorders of the Cardiovascular System; Harrison's Principles of Internal Medicine 17th, and Self-assessment & Board Review cardiovascular system questions 15, 29
- ^ Lua error in Module:Citation/CS1/Configuration at line 2172: attempt to index field '?' (a nil value).
- ^ synd/1368 at Whonamedit?
- ^ A. Kussmaul. Über schwielige Mediastino-Perikarditis und den paradoxen Puls. Berliner klinische Wochenschrift, 1873, 10: 433–435, 445-449 and 461-464.
- ^ Kussmaul's respiration at Whonamedit?