This sign is used as an adjunct while investigating the jugular venous pressure.
- The sign is positive when there is a paradoxical rise in JVP or absence of JVP depression during inspiration
- Normally, when inspecting the JVP, it declines during inspiration but the amplitude of the A wave increases.
- A positive kussmaul's sign suggests impaired venous return to the right heart
- A positive sign is most commonly associated with right-sided congestive heart failure, but can also be caused by superior vena cava obstruction
- A positive sign may also be an indication of severe right-sided heart failure, constrictive pericarditis, myocardial restrictive disease, SVC syndrome or tricuspid stenosis
- Chatterjee K. Examination of the Jugular Venous Pulse. September 2010. Uptodate Online 18.3. Accessed January 3rd 2011 from http://www.uptodate.com/online/content/topic.do?topicKey=cardeval/2280&selectedTitle=4~150&source=search_result#H20.