Jugular venous pressure and pulse wave form in the diagnosis of right ventricular infarction

Jugular venous pressure (measured clinically) and pulse wave form (recorded at 100 mm/s) were analysed in 44 cases of first acute myocardial infarction and 10 age-matched controls. Patients were divided into different groups according to site of infarction decided by detailed 2-D echocardiography. Raised jugular venous pressure had high specificity (96.8%) but low sensitivity (39%) in diagnosing right ventricular infarction. Positive Kussmaul's sign had equal specificity but lower sensitivity (26.1%). Rapid 'y' descent had high specificity (100%) but low sensitivity (17.3%) in diagnosing right ventricular infarction. Jugular venous pressure and pulse wave form are significantly affected by the magnitude of damage to interventricular septum and left ventricular free wall.