Hepatojugular reflux: Useful in the bedside diagnosis of tricuspid regurgitation

Using phonocardiography and auscultation, we ascertained the presence or absence of hepatojugular reflux and Carvallo's maneuver in three groups of 15 patients. The first group had isolated tricuspid regurgitation; the second, isolated mitral regurgitation; and the third was a control group with no murmurs. The specificity and sensitivity of hepatojugular reflux were 100% and 66%, and those of Carvallo's maneuver were 100% and 80%. All but 1 patient in our series had a positive response to one or the other maneuver (combined sensitivity, 93%). Thus, hepatojugular reflux is a useful adjunct to Carvallo's maneuver in the diagnosis of tricuspid regurgitation.