Case 7 Cardiology

Exertional Dyspnea

Work it one clue at a time. The diagnosis stays hidden until you reveal it.

Clue 1

A 50-y/o man presents with exertional dyspnea. The two main systems responsible for dyspnea are the heart and the lungs.

Clue 2

The jugular venous pulse can serve as a pivot point. It can take you toward or away from the heart. With this in mind, you evaluate the patient’s neck. What do you notice?

Not only is the JVP elevated, but it appears to rise with inspiration. This is known as Kussmaul’s sign.

In the above video, you may have also noticed a mark on the patient’s skin, just below the “a wave” in our logo. Here is the mark up close:

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