Kussmaul's sign – Causes, Mechanism

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  • Kussmaul’s sign refers to the inspiratory increase in jugular venous pressure (or central venous pressure)
  • Some sources consider Kussmaul’s sign as the absence of inspiratory fall in jugular venous pressure


  • Constrictive pericarditis
  • Restrictive cardiomyopathy


  • Normally there is inspiratory decrease in JVP (Read Mechanism of inspiratory decrease in JVP)
  • In the conditions mentioned above, the pericardium / myocardium is stiff
  • The negative intrathoracic pressure is not transmitted to the heart
  • The heart cannot accommodate the increased blood flow that occurs during inspiration
  • Hence the jugular venous pressure will be elevated

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Mechanism of inspiratory decrease in JVP

The jugular venous pressure falls during inspiration The mechanism is as follows During inspiration, there is increase in negative intrathoracic...