Hepato-jugular reflux sign positive

Introduction Positive jugular venous return sign refers to the recurrent episode of chronic congestive heart failure when right heart failure causes hepatic congestion. Long-term congestion and hypoxia, resulting in liver reticular fibrous tissue hyperplasia, mainly in the center of the hepatic lobules with star-shaped fibrosis, fibrous tissue segmentation of the hepatic lobule to form irregular cell mass by hand to oppress the liver to make the jugular vein anger more obvious, said Positive for the jugular vein return. The hypertrophic pericardium compresses the heart, which greatly limits the diastolic filling of the heart, resulting in increased right ventricular end-diastolic pressure and right atrial pressure, resulting in obstruction of hepatic venous blood flow, continuous increase of hepatic venous pressure, hepatic central sinus dilatation, congestion, and hemorrhage. As a result, hepatocytes lack hypoxia and necrosis.

Cause

1. Liver tumors, abscesses, cysticercosis, and swollen lymph nodes cause the hepatic vein to be compressed.

2. A thrombus is formed in the hepatic vein or its branches.

3. A lung disease that causes incomplete heart function.

4. Heart disease with left ventricular insufficiency.

5. Cycling disorders caused by parasitic mites.

an examination

Related inspection

Cardiovascular electrocardiogram

1. Increased ascites: due to hepatic congestion, veins in the intestine, mesentery, omentum, etc. of the portal vein and the portal vein. In addition, lesions of hepatocytes reduce albumin synthesis and decrease plasma osmotic pressure. For these reasons, leakage of ascites is increased.

2. Vomiting: Hepatomegaly and increased ascites cause the stomach to be oppressed, causing vomiting.

3. Various symptoms presented during congestive heart failure.

4. The spirit is sluggish.

5. Loss of appetite.

6. Weight loss.

Differential diagnosis

Clinically often differentiated from left heart failure.

1, left heart failure, breathing difficulties: labor difficulty breathing, heavy can not sit flat, sitting and breathing.

Cough, cough and hemoptysis: often white foam, heavy pink foam .

The main signs are the apical period of diastolic galloping and alternating veins, and the bottom of the lungs can smell wet rales and wheezing.

2, liver enlargement: due to congestion, increased blood volume in the liver, the size and weight of the liver increased. The liver that is not accessible at the trailing edge of the rib arch at normal time can be touched at this time.

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