Hepatojugular reflux

Hepatojugular reflux is a medical term that refers to an increase in jugular venous pressure observable by physical examination of the neck veins during sustained pressure over the liver. It is a sign of right heart failure or constrictive pericarditis.

Overview

Hepatojugular reflux is a physical examination finding that is often used to assess the function of the right side of the heart. When the liver is compressed, it causes an increase in the blood flow from the liver to the right atrium. If the right side of the heart is functioning normally, it should be able to handle this increase in blood flow without a significant increase in the jugular venous pressure. However, if the right side of the heart is failing, the increased blood flow will cause a noticeable increase in the jugular venous pressure.

Clinical Significance

Hepatojugular reflux is a useful clinical sign in the diagnosis of several conditions, including right heart failure and constrictive pericarditis. It can also be seen in tricuspid regurgitation and cardiac tamponade. The presence of hepatojugular reflux is a sign of increased central venous pressure.

Examination

The examination for hepatojugular reflux is performed with the patient in a semi-upright position. The examiner places his or her hand over the patient's liver and applies gentle pressure for 10 to 15 seconds. The examiner then observes the patient's neck veins for any increase in distention.

See Also

• Jugular venous pressure
• Right heart failure
• Constrictive pericarditis
• Tricuspid regurgitation
• Cardiac tamponade

References

Hepatojugular reflux Resources
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