China
Africa
Explore chapters and articles related to this topic
Geriatric Assessment and the Physical Examination of the Older Adult
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
The hepatojugular reflux can confirm that the pulsations originate in the jugular venous pulse. The pressure to the right upper quadrant has to be sustained and the height of the column should have a demonstrable sustained rise, immediately after the hepatic pressure is applied.
Do we need a definition of acute heart failure with preserved ejection fraction?
Published in Annals of Medicine, 2021
Agnieszka Kapłon-Cieślicka, Lars H. Lund
Regardless of EF category, when validated externally, HF could be potentially misdiagnosed in 15–50% of hospitalised patients and half of the ambulatory, primary care patients [21,23–29]. This demonstrates the need to objectify HF diagnosis which is still most often made clinically [21,23–29]. The proposed integrated approach, presented in Figure 1, is based on objective evidence from different diagnostic tests in patients with an initial clinical diagnosis of acute HFpEF. While the leading symptoms and signs of HF are less specific (dyspnoea, pulmonary rales, tachycardia, peripheral oedema), some signs (third heart sound, elevated jugular venous pressure, hepatojugular reflux) may be more specific for HF, but are not always present (e.g. third heart sound present in 30%, and elevated jugular venous pressure in 35% of acute HF patients) [11,30]. Importantly, all HF symptoms and signs may occur in patients with volume overload (e.g. in renal failure) and/or high-output states (e.g. anaemia, thyrotoxicosis, arteriovenous shunts, liver disease), even in the absence of an underlying LV disease. Those clinical symptoms and signs can mimic HF but will resolve once the primary cause is appropriately treated [11]. This underscores the need for an accurate assessment of features of chronic LV abnormalities in a patient with a clinical suspicion of acute HFpEF.
Distension of the maxillary vein with hepatojugular reflux
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
A 92-year old woman presented to the emergency department with worsening dyspnea. She was found to be in atrial fibrillation with rapid ventricular response. Physical examination revealed hepatojugular reflux with venous distension extending to the level of the maxillary vein (arrow). Chest radiograph showed new bilateral interstitial changes and pro-brain natriuretic peptide level was elevated.
Update on diagnosis and management of neoplastic pericardial disease
Published in Expert Review of Cardiovascular Therapy, 2020
Stefano Avondo, Alessandro Andreis, Matteo Casula, Massimo Imazio
Pericardial effusion is usually secondary to lymphatic drainage impairment, sometimes leading to cardiac tamponade, a clinical scenario requiring urgent treatment. Clinical examination may reveal pericardial rubs, pulsus paradoxus, hepatomegaly, hepatojugular reflux, jugular distension, muffled heart sounds, cyanosis and abolished lung sounds in case of concomitant pleural effusion [13].