Measurable in the veins of the arm, produced in active or impending congestive heart failure chf and constrictive pericarditis by firm pressure with the flat hand over the abdomen often called hepatojugular reflux when pressure is exclusively over the liver. Cv merger may indicate cor pulmonale with tricuspid valvular regurgitation 10. Physical diagnosis of chronic obstructive pulmonary disease. Additionally, hepatojugular reflux is a useful adjunct to jugular venous distention in the diagnosis of cor pulmonale. When several of the medical students, during a clinical assessment, told me that they were eliciting the hepatojugular reflex i began to wonder if i had it wrong.
A positive ajr test correlates with the pulmonary artery pressure and thus is a marker for right heart dysfunction, specifically right ventricular failure. It is true that they werent able to tell me what the relevant reflex arc might be, and one of them even told me that the idea that blood could be made to flow backthat is. V wave with loss of x decent cv merger may indicate cor pulmonale with tricuspid valvular regurgitation 10. The abdominojugular test, also known as abdominojugular reflux ajr, is a physical examination test useful in diagnosing right ventricle dysfunction, particularly right ventricular failure. Ajr is a test for measuring jugular venous pressure jvp through the distention of the internal jugular vein. The hepatojugular reflux, as presently defined, consists of a distention of the neck veins when pressure is applied over the liver. Hepatojugular reflux hjr, described as a sign of regurgitation of the tricuspid valve, may reflect structural and functional changes of the lv in the hypertensive patient. It is true that they werent able to tell me what the relevant reflex arc might be, and one of them even told me that the idea that blood could be made to flow backthat is, refluxthrough the venous circulation simply by. Additionally, hepatojugular reflux is a useful adjunct to jugular venous distention in the diagnosis of cor pulmonale with tricuspid regurgitation 11. Request pdf is hepatojugular reflux a good predictor of heart failure with preserved ejection fraction.
Retrograde flow, usually anomalous, of an organic fluid within a conduit or hollow organ. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. It has subsequently been believed to be useful in the diagnosis of congestive heart failure. Hypertension may occur with left ventricular lv diastolic dysfunction, and the. Is hepatojugular reflux a good predictor of heart failure. Clinical and hemodynamic assessment of the hepatojugular. With a competent heart, pressure on the liver does not elevate the venous blood level in the neck veins when the subjects are in the semirecumbent position.
267 1355 142 316 1396 827 1312 820 1236 1155 853 1121 823 453 942 357 806 1091 395 968 1231 229 1434 1476 1206 1347 935 732 7 619 1258 494 289 532 578 1401