MRCP UK EXAMINATIONS

Detailed explanation-1: -Kussmaul sign is the paradoxical increase in jugular venous pressure with inspiration, observed in conditions associated with limited filling of the right ventricle. It is typically associated with constrictive pericarditis, although it occurs in only a minority of people with this condition.

Detailed explanation-2: -Increased jugular venous pressure with inspiration is commonly referred to as Kussmaul’s sign; and the disappearance of the radial pulse or a drop in systolic blood pressure of 10 mmHg or greater with inspiration is recognized as pulsus paradoxus.

Detailed explanation-3: -Under normal conditions, decreased intrathoracic pressure during inspiration augments venous return to the right side of the heart, which is easily accommodated by a compliant right ventricle, leading to a decrease in JVP.

Detailed explanation-4: -Kussmaul’s sign, or a lack of fall of the jugular venous pressure with inspiration, usually denotes a lack of compliance in the right ventricle, as seen most frequently in constrictive pericarditis, though it may be found in restrictive cardiomyopathy or massive pulmonary embolism.