Definitions

kussmaul's coma

Kussmaul's sign

Kussmaul's sign is the observation of a jugular venous pressure (JVP, the filling of the jugular vein) that rises with inspiration. It can be seen in some forms of heart disease. It is usually indicative of right ventricular dysfunction along with hypotension and "dry lungs" (absence of pulmonary edema).

Background

Ordinarily the JVP falls with inspiration due to reduced pressure in the expanding thoracic cavity. Kussmaul's sign suggests impaired filling of the right ventricle due to either fluid in the pericardial space or a poorly compliant myocardium or pericardium.

Causes

Possible causes of Kussmaul's sign include:

History

Kussmaul's sign is named after the German doctor who first described it, Adolph Kussmaul (1822-1902) He is also credited with describing Kussmaul breathing.

References

Fauci, Braunwald, Kasper, Hauser, Longo, Jameson & Loscalzo (2008). Harrison's Principles of Internal Medicine (17th ed). McGraw Hill: Toronto, ON.

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