Kussmaul's sign

Kussmaul's sign is a medical term that refers to an abnormal increase in jugular venous pressure, observable as a rise in the jugular vein when the patient breathes in. This is a paradoxical physical finding in certain conditions, as the pressure typically decreases with inspiration. It is named after the German physician Adolf Kussmaul, who first described the sign in patients with pericarditis.

Causes

Kussmaul's sign is seen in conditions that cause an obstruction to the filling of the right ventricle. This includes constrictive pericarditis, restrictive cardiomyopathy, right atrial tumor, and severe right ventricular failure. It can also be seen in tricuspid stenosis and pulmonary hypertension.

Pathophysiology

The pathophysiology of Kussmaul's sign involves the inability of the right ventricle to accept blood during inspiration. This is due to the increased rigidity of the pericardium in conditions such as constrictive pericarditis, which prevents the normal expansion of the right ventricle and leads to an increase in venous pressure.

Clinical significance

Kussmaul's sign is a useful clinical sign in the diagnosis of certain cardiac conditions. It is particularly helpful in distinguishing constrictive pericarditis from restrictive cardiomyopathy, as it is usually present in the former and absent in the latter.

See also

• Jugular venous pressure
• Adolf Kussmaul
• Pericarditis
• Cardiomyopathy

References

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