Cornell's sign

Cornell's sign is a clinical sign in which there is an increase in the jugular venous pressure (JVP) on inspiration. It is seen in patients with constrictive pericarditis and is one of the manifestations of Kussmaul's sign.

Overview

The jugular venous pressure is a measure of the pressure within the jugular veins, which return blood from the head and neck to the heart. Normally, the JVP falls on inspiration as the negative intrathoracic pressure is transmitted to the heart and the right atrium fills with blood. However, in constrictive pericarditis, the pericardium (the sac surrounding the heart) is thickened and inelastic, preventing the right atrium from expanding and filling with blood. This leads to an increase in the JVP on inspiration, known as Cornell's sign.

Clinical Significance

Cornell's sign is a useful clinical sign in the diagnosis of constrictive pericarditis. It is one of the manifestations of Kussmaul's sign, which also includes paradoxical increase in the JVP on inspiration and a rapid y descent in the jugular venous pulse.

Diagnosis

The diagnosis of constrictive pericarditis can be challenging, but the presence of Cornell's sign can provide a valuable clue. It is usually detected on physical examination, by observing the neck veins of the patient during respiration. Other diagnostic tests for constrictive pericarditis may include an echocardiogram, cardiac MRI, and cardiac catheterization.

Treatment

The treatment for constrictive pericarditis is usually surgical, involving a pericardiectomy, which is the surgical removal of the pericardium. This can relieve the symptoms and improve the prognosis for patients with this condition.

See Also

• Kussmaul's sign
• Constrictive pericarditis
• Jugular venous pressure
• Pericardiectomy

References

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