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Hepatojugular Reflux: Useful in the Bedside Diagnosis of Tricuspid Regurgitation

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Presented in part at the Fifty-Sixth Scientific Session of the American Heart Association, Anaheim, California, November 1983.

▸Requests for reprints should be addressed to Alan Maisel, M.D.; Division of Cardiology, Department of Medicine, University of California, San Diego; San Diego, CA 92103.

San Diego, California

© 1984 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1984;101(6):781-782. doi:10.7326/0003-4819-101-6-781
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Using phonocardiography and auscultation, we ascertained the presence or absence of hepatojugular reflux and Carvallo's maneuver in three groups of 15 patients. The first group had isolated tricuspid regurgitation; the second, isolated mitral regurgitation; and the third was a control group with no murmurs. The specificity and sensitivity of hepatojugular reflux were 100% and 66%, and those of Carvallo's maneuver were 100% and 80%. All but 1 patient in our series had a positive response to one or the other maneuver (combined sensitivity, 93%). Thus, hepatojugular reflux is a useful adjunct to Carvallo's maneuver in the diagnosis of tricuspid regurgitation.





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