Clinical features

• Ask the patient relax and breath through an open mouth. Place the palm of your hand on the mid-abdomen and push at pressure 20 to 35 mmHg for 15 to 30 seconds
  • positive if sustained increase in JVP ≥ 4cm
  • negative if sustained increase ≤ 3cm, or transient increase ≥ 4cm

Repeat the test if there is pain, the patient holds his breath or bears down. 

Why

An abnormal abminojugular reflex makes congestive heart failure more likely

Patient	Target Disorder and Reference Standard	Diagnostic Test	LR+ (95% CI)	Post-test Probability	LR- (95% CI)	Post-test Probability
suspected congestive heart failure b (pre-test probability: 25%)	congestive heart failure (clinicoradiographic score)	abnormal abdomino-jugular reflex	6.0 (1.3 to 29)	67%	0.7 (0.5 to 1.1)	19%