The abdominojugular (reflux) test is a physical examination maneuver that is performed by placing firm pressure over the patient’s abdomen with the palm of the hand while observing the effect on jugular venous pressure. This test has several applications. First, it can serve to distinguish a venous pulse (will rise with abdominal pressure) from an arterial pulse (no change with abdominal pressure). Second, a sustained rise in jugular venous pressure of >3 cm lasting more than 10 to 15 seconds while abdominal pressure is continuously applied, is highly suggestive of elevated wedge pressure >15 mm Hg.

Patient 1:

This patient was admitted to the hospital for decompensated heart failure with preserved systolic function. Note the positive abdominal jugular reflux test. In some cases, the jugular venous pulse is better visualized on the left than the right.

Patient 2:

This is a middle-aged woman with a history of congenital heart disease.

Submitted by Dr. Craig Broberg, Oregon Health and Science University.