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The abdominojugular reflux sign.

¹General Internal Medicine Section, VA Medical Center, San Francisco, California 94121, USA.

The American Journal of Medicine

|August 11, 2000

Summary

The abdominojugular reflux sign aids in diagnosing right ventricular failure but is often done incorrectly. This sign indicates a right ventricle unable to handle increased venous return, seen in conditions like constrictive pericarditis.

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Area of Science:

Cardiology
Physiology

Background:

The abdominojugular reflux sign is a clinical examination technique.
It is used to assess right ventricular function and diagnose heart failure.
Accurate performance and interpretation are crucial but often lacking.

Purpose of the Study:

To review the historical context, epidemiology, and underlying pathophysiology of the abdominojugular reflux sign.
To clarify the correct methodology and interpretation of the sign.

Main Methods:

A comprehensive literature search was conducted using MEDLINE (1966-1999).
A manual review of bibliographies from relevant articles was also performed.

Main Results:

A positive sign is defined as a sustained increase in jugular venous pressure (>3 cm for >15 seconds).
It suggests impaired right ventricular preload, compliance, systolic function, or elevated afterload in the absence of left heart failure.
The sign predicts congestive heart failure and elevated pulmonary capillary wedge pressures.

Conclusions:

The abdominojugular reflux sign reflects a compromised right ventricle's inability to manage increased venous return.
Common causes include constrictive pericarditis, right ventricular infarction, and restrictive cardiomyopathy.
Left ventricular failure can cause the sign if pulmonary capillary wedge pressure exceeds 15 mm Hg; cardiac tamponade is an exception.

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