Kussmaul's Sign on JVP Examination



The main finding on this video I hoped to demonstrates is #kussmauls sign - paradoxical rise in JVP with inspiration.

Physical Dx guru @AndreMansoor aptly pointed out there is an arterialization look to it and invoke Lancisi’s Sign which is a giant V wave in Tricuspid Regurgitation.

It does have arterialization to it, but I’m less suspicious for frank TR. Rather, this patient has a failed AVF and newly placed AV Graft in his left arm. I’m suspicious for high a throughput graft which has overloaded his RV, and could account for arterialization and his ⬆️ RVDP



R Logan Jones, M.D. @rloganjonesmd



#Kussmauls #Sign #PhysicalExam #Video #Clinical #JVP #Neck #Veins #Cardiology