Kussmaul's Sign on Physical Exam Kussmaul sign is a paradoxical rise in jugular venous pressure (JVP) on inspiration, or a failure in the appropriate fall of the JVP with inspiration. Normally, venous pressure should drop at least 3 mmHg with inspiration. The Kussmaul sign is defined by an increase (or lack of fall) of jugular venous pressure with inspiration and is classically associated with constrictive pericarditis, although it has been reported in patients with restrictive cardiomyopathy, m
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- Kussmaul sign is a paradoxical rise in jugular venous pressure (JVP) on inspiration, or a failure in the appropriate fall of the JVP with inspiration. It can be seen in some forms of heart disease and is usually indicative of limited right ventricular filling due to right heart dysfunction. Ordinarily the JVP falls with inspiration due to reduced pressure in the expanding thoracic cavityand the increased volume afforded to right ventricular expansion during diastole. Kussmaul sign suggests imp
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