Case 2:

63-year old woman presented with central chest pain of two hours duration. On examination her blood pressure was 90/60 mm Hg, she had a weak pulse, distended neck veins with elevated jugular venous pressure, normal first and second heart sounds and lung fields were clear on auscultation.

Ragavendra R. Baliga, M.D
Assistant Professor
Division of Cardiology
University Of Michigan

 

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Question 4 of 17:

The presence of distended neck veins alone is sensitive and specific for right ventricular ischemia in patients with inferior wall MI.

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Distended neck veins alone or the presence of Kussmaul's sign (distension of jugular vein on inspiration) are both sensitive and specific for RV ischemia in patients with an inferior MI (1). These findings may be masked in the setting of volume depletion and may become evident only after adequate volume loading.

Reference:

1. Dell'Italia LJ, Starling MR, Crawford MH, Boros BL, Chaudhuri TK, O'Rourke RA. Right ventricular infarction: identification by hemodynamic measurements before and after volume loading and correlation with non-invasive techniques. J Am Coll Cardiol 1984;4:931-939.

 
 
 
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