Kussmaul's Sign and Friedreich's Sign on Neck Examination



A middle-aged M with unknown PMH presents with dyspnea. What 2 eponymous JVP findings are demonstrated in the video? Most likely diagnosis? What is that small blue-colored spot on the skin (middle chest, lower part of screen) that might suggest the underlying cause?



Kussmaul's (JVP rise w inspiration) + Friedreich's (sharp/deep Y-descent) + XRT tattoo = constrictive pericarditis 2/2 remote XRT. Pt was amazed - he hadn't disclosed hx of Hodgkin's (hospitalized for unrelated problem). "You figured that out just by looking at me?"



Dr. André Mansoor @AndreMansoor - Author of Frameworks for Internal Medicine https://amzn.to/2LmUODZ



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