Abdominojugular test

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Abdominojugular test
right ventricle
dysfunction

The abdominojugular test, also known as abdominojugular reflux (AJR), is a physical examination test useful in diagnosing

right ventricular failure.[1]

AJR is a test for measuring

Reflux in this context means backup of the circulatory system and is not to be confused with reflex.[3]

Procedure

The patient is asked to lie down at 30 degrees with his/her head tilted 45 degrees to the left. Then an oblique light is used to illuminate the jugular region of the neck to help in identifying the internal jugular vein. Care must be taken not to confuse it with the external jugular, whose beating is more easily seen under the skin due to it being more superficial. In patients with severe right heart congestion, observation of the internal jugular might not be feasible due to its distention all the way into the upper neck and skull.[citation needed]

The clinician presses firmly over either the

right upper quadrant of the abdomen (i.e., over the liver) or over the center of the abdomen [2] for 10 seconds with a pressure of 20 to 35 mm Hg while observing the swelling of the internal jugular vein in the neck and also observing to be sure the patient does not perform a Valsalva maneuver.[4]

On an otherwise healthy individual, the jugular venous pressure remains constant or temporarily rises for a

Budd-Chiari syndrome
.

A positive result is variously defined as either a sustained rise in the JVP of at least 3 cm or more

specificity
of 93% to 96%. The large discrepancy in sensitivity may be explained by the higher value being reported during performance in optimal conditions of a cardiac lab while the lower value was from a study in an emergency department.

References