Loading....
Coupon Accepted Successfully!

Medicine

Open Flashcards

Cardiology

Question
6 out of 19
 

Kussmaul's sign is NOT seen in (NEET 2013)



A Restrictive cardiomyopathy

B Constrictive pericarditis

C Cardiac tamponade

D R V infarct

Ans. C

Cardiac tamponade

Clinical features:


1. These are mainly of right heart failure with raised JVP;

2. 2 Kussmaul's sign Q is positive (JVP rising inspiration)

3. Prominent Y descent,

4. Prominent X descentQ

5. Diastolic pericardial knockQ, (S3) is present,

6. Hepatosplenomegaly, ascites, and oedema,

7. Retractile apex beat (broadbend sign)

8. Faint heart sound (Quite heart)


Extra Edge: Diastolic pericardial knock(it is S3) is heard in early diastole.

DD: Cirrhosis of liver Q (Because of associated ascites. Splenomegaly)

Extra Edge: (Ref. Hari-18th ed., Pg- 1823)

Normally, the venous pressure should fall by at least 3 mmHg with inspiration. Kussmaul's sign is defined by either a rise or a lack of fall of the JVP with inspiration.

Causes of Kussmaul sign:

1. CP

2. RV infarct

3. Restrictive CM

4. TS

5. Advanced LV systolic failure

6. Massive pulmonary embolism.

Important points

1. Ascites is out of proportion to oedema in CP.

2. Acute pulmonary oedema is not a feature of CP.

Tests:

1. CXR: small heart pericardial calcification (if none, CT/MRI helps distinguish from other cardiomyopathies).

2. Echo; will show thickened pericardium

3. Cardiac catheterization reveals ventricle diastolic pressure shows square root sign or deep and plateau sign.

Cardiology Flashcard List

19 flashcards
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
14)
15)
16)
17)
18)
19)