Describe about Abdominojugular and Hepatojugular Reflux ?

The term was first coined in 1885 to test the further rise in jugular venous pressure to elicit presence of h;art failures in patients with hepatomegaly and tricuspid regurgitation. It is also known as Abdominal Compression Test. The test is carried out by pressing the right upper quadrant of abdomen with outstretched fingers while lying elevated at 30' on a back rest and slowly increasing the pressure to see the rise of jugular venous pressure 3.4 cm above the basal line. The degree of pressure must not cause any discomfort or pain to the patient as this will vitiate the interpretation. The raised venous pressure would persist as long as the compression is continued thus unmasking raised systemic venous pressure otherwise unperceived. In normal individuals the jugular venous pressure may rise transiently to fall to basal level on continued compression of abdominal wall as this will result in compression of the inferior vena cava impeding venous return to RA with consequent fall in RA pressure. If right upper quadrant is tender, any part of upper abdominal wall may be compressed. In case of congestive failure both RA and RV are no completed due to over distension compounded by raised sympathetic tone. Rise of venous pressure will continue on compression.

However, false positive rise in venous pressure may be noted in patients with severe obstructive pulmonary disease, due to inability to tolerate any further rise in diaphragm, resulting from severe loss of vital capacity. Similarly any increase in blood volume like Polycythaemia Rubra Vera or excessive sympathetic stimulation like nervousness, pain may produce a positive result in absence of congestive heart failure. In interpretation of positive result one must be careful that increase pulsation should not be mistaken for raised venous pressure. This subtle positive sign may alert the attending physician of the possible presence of significant RV infarction complicating a case of inferior infarction.