Kussmaul Sign and inspiration

Hi brainy folks, Kussmaul Sign is a paradoxical rise in jugular venous pressure (JVP) on inspiration, or a failure in the fall of the JVP along with inspiration. It is seen in heart disease with limited right ventricular filling due to right heart dysfunction.

What happens normally- when there is inspiration there is negative intrathoracic pressure, this negative pressure increases right ventricular filling, since there is increased blood flow into the heart the jugular venous pressure decreases.

But in diseases impairing right ventricular filling causes rise in JVP with inspiration. Most common cause for reduced filling is decreased compliance of right ventricle or whole heart, e.g. Restrictive cardiomyopathy.

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