Physical Exam

Abdominojugular Reflux

also known as Hepatojugular reflux

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Video coming September 2026

How to Perform

With the patient reclining at about 45° and the jugular pulsation visible, apply firm, steady pressure over the mid-abdomen for 10 seconds while the patient breathes normally, and watch the neck veins. A positive test is a sustained rise in the jugular venous pressure of more than 3 cm that persists throughout compression and falls when you release the pressure.

How to Interpret

Elevated Pulmonary Capillary Wedge Pressure

Pulmonary Capillary Wedge Pressure Above 15 mm Hg

Positive abdominojugular (hepatojugular) reflux

Rule in

Somewhat helpfulDerived CI

Rule out

InconclusiveWide CI

Evidence:Limited

Heart Failure

Abdominojugular reflux positive

Rule in

Somewhat helpfulDerived CI

Rule out

Not helpfulDerived CI

Evidence:Strong

References

Iwata H, Miwa Y, Ikehara Y, Yodoshi T, Ueda S. The clinical value of hepatojugular reflux on congestive heart failure: A meta-analysis. J Gen Fam Med. 2022;23(6):393-400. doi:10.1002/jgf2.574. PMID: 36349209.
Maisel AS, Atwood JE, Goldberger AL. Hepatojugular reflux: useful in the bedside diagnosis of tricuspid regurgitation. Ann Intern Med. 1984;101(6):781-2. PMID: 6497192.
Sochowski RA, Dubbin JD, Naqvi SZ. Clinical and hemodynamic assessment of the hepatojugular reflux. Am J Cardiol. 1990;66(12):1002-1006. PMID: 2220606.
Ewy GA. The abdominojugular test: technique and hemodynamic correlates. Ann Intern Med. 1988;109(6):456-460.

Research last updated September 9, 2026.