Kussmaul's sign is an increase in the jugular venous pressure with inspiration. Normally during inspiration, the negative intrathoracic pressure causes a fall in systemic venous pressure and therefore a drop in the jugular venous pressure. However, in patients with constrictive pericarditis, the thickened pericardium causes the transmission of intrathoracic pressure to the chambers of the heart to fail; thus the venous pressure does not decrease.
What is a continuous murmur? With which cardiac abnormalities is it associated?
A continuous murmur is one that begins in systole and continues without interruption through the timing of the second heart sound into all or part of diastole. It is generated by flow from a zone of high resistance to one of low resistance.
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Continuous murmurs are associated with aortopulmonary connections, such as patent ductus arteriosus; arteriovenous connections, such as anomalous origin of the left coronary artery from the pulmonary trunk; coronary artery fistulas; and sinus of Valsalva to right heart connections.