Kissing mouth sign

Adolf Kußmaul (1822-1902) was the first to describe the Kußmaul sign, which was also named after him.

A kiss-mouth sign is the paradoxical increase in pressure in the jugular vein during inspiration (Herold 2018).

The kissing mouth sign can occur with:

• acute pericarditis
• chronic constrictive pericarditis
• Tricuspid stenosis

(Mansoor 2015)

The normally reduced inspiratory intrathoracic pressure leads to an increase in venous return flow towards the right heart and, consequently, to a decrease in pressure in the area of the jugular veins. However, as soon as the filling of the right ventricle is impaired, the jugular veins fill instead.

(Mansoor 2015)

1. Herold G et al (2018) Internal Medicine. Herold Verlag 235, 237
2. Mansoor A M et al (2015) Kussmaul's Sign. N Engl J Med (372) e3