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Hepatojugular reflux Definition, Test, Mechanism, Pathophysiology

   

Whenever pressure is applied to abdomen and it is compressed, it leads to distension of jugular vein. Physiology behind distension of hepatojugular vein or hepatojugular reflux is, when abdomen is compressed for 20 to 30 seconds, the venous pressure increases towards right side of ventricle of heart, if the right ventricle is not healthy and not working properly then it cannot handle that increased pressure of blood and as a result lead to distension of jugular vein. This mechanism is known as hepatojugular reflux. Hepatojugular reflux is a historical term used to explain abdominojugular reflux or another name of abdominojugular test. Basically hepatojugular reflux is an indication of right and/or left ventricle disease or failure.


This reflux occurs in about 70 % of cases with heart disease. Hepatojugular reflux is an early sign of congestive heart failure. It is named as hepatojugular reflux because of increased blood pressure in peripheral nervous system which increases load on liver and ultimately distension of jugular vein occurs which is present in neck. When heart is in healthy condition, it increases the cardiac output due to increased venous return. This will not increase load on liver and as a result there will be no distension in jugular vein.

Hepatojugular reflux Definition, Test, Mechanism, Pathophysiology


Hepatojugular reflux Test

           
Hepatojugular reflux is also known as abdominojugular test. It is a physical test which is performed to check performance of heart. If the result is positive, it shows problem in pulmonary artery pressure and indicates right heart dysfunction. In this test patient is asked to lie down at 30 degrees and head tilted at 45 degrees to left side. Direct light is applied on neck to see the difference in jugular vein appearance. Patient’s abdomen is compressed lightly for about 20 to 30 seconds and distension in jugular vein will be seen.


Hepatojugular reflux Mechanism

        
Hepatojugular reflux is an indication of heart failure or many other cardiac diseases. Because it occurs as a result of cardiac failure or diseased state of heart. When a light pressure is applied, abdomen get compress and after 20 to 30 sec of compression the venous return pressure increases, which increases pressure on liver. Increased blood pressure on liver leads to increased blood pressure in cranial vena cava ultimately increasing pressure on jugular veins leading to distension of vein. Jugular veins are present in neck region which can be easily seen on surface after expansion or distension.


Hepatojugular reflux Pathophysiology

       
Hepatojugular reflux is a normal physical test which is performed to check performance of heart. The pathophysiology behind this reflux is dependent upon the impaired condition of heart. When right or left ventricle is diseased, increased venous return pressure on right ventricle cannot be handled by it. And leads to increased peripheral nervous pressure. This increased pressure start increasing load on liver and liver pass this pressure on cranial nerves and ultimately jugular vein. As a result jugular vein get distended. All this happen due to diseased state or failure of heart. This condition mostly indicate congestive heart failure.

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