Kussmaul's sign is NOT seen in (NEET 2013)
|D||R V infarct|
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:
2. RV infarct
3. Restrictive CM
5. Advanced LV systolic failure
6. Massive pulmonary embolism.
1. Ascites is out of proportion to oedema in CP.
2. Acute pulmonary oedema is not a feature of CP.
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.