Positive hepatojugular reflux is found in all of the following conditions except-: (A) Tricuspid regurgitation, (B) Right hea failure, (C) Decreased after load, (D) Increased capillary bed pressure
Answer is C. Abdomino jugular reflex is mainly seen in impending right ventricular failure. JVP remains raised >3cm for >15sec HEPATOJUGULAR REFLUX --Raising the legs or abdominal compression increases venous return and pressure and facilitates analysis of the jugular venous pulse. --The hepatojugular or abdominojugular reflux is assessed by applying firm, sustained pressure for 10 to 15 seconds over the upper abdomen while the patient is breathing quietly. --In normal subjects this maneuver transiently increases jugular pressure by only approximately 1-3 cm. --In patients with right ventricular failure, however, sustained elevation of venous pressure usually greater than 3 cm is observed during continued compression (positive hepatojugular reflux). --It is assumed that a failing right ventricle is unable to respond normally to the increased preload caused by increased venous return with abdominal compression and elevated intraabdominal pressure++ a raised diaphragm during abdominal compression compromises cardiac filling by decreasing the intrathoracic and mediastinal volumes available for cardiac expansion. Ref: Harrisons 20th edition pg 1441