Kussumau's sign is most commonly seen in-

Kussmaul sign is a paradoxical rise in jugular venous pressure (JVP) on inspiration, or a failure in the appropriate fall of the JVP with inspiration. It can be seen in some forms of hea disease and is usually indicative of limited right ventricular filling due to right hea dysfunction. The differential diagnosis generally associated with Kussmaul sign is constrictive pericarditis, as well as with restrictive cardiomyopathy. With cardiac tamponade, jugular veins are distended and typically show a prominent x descent and an absent y descent as opposed to patients with constrictive pericarditis (prominent x and y descent), see Beck's triad Other possible causes of Kussmaul's sign include: Right ventricular infarction - low ventricular compliance Right hea failure Cardiac tumours Tricuspid stenosis Restrictive cardiomyopathy Pulmonary embolism Constrictive pericarditis Ref Harrison 20th edition pg 1435