Positive hepatojugular reflux is found in conditions except:
**Core Concept**
Positive hepatojugular reflux (HJR) is a clinical sign indicating right heart failure or increased intrathoracic pressure, leading to a palpable liver edge on inspiration. It occurs when the liver is elevated and pushed against the diaphragm due to increased jugular venous pressure.
**Why the Correct Answer is Right**
Positive HJR is typically seen in conditions that increase venous pressure, such as right heart failure, constrictive pericarditis, or significant tricuspid regurgitation. The increased pressure in the jugular veins causes the liver to be pushed upwards, resulting in a positive HJR. This is because the liver is not able to drop back down into its normal position during inspiration due to the increased pressure.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is likely to be incorrect because conditions like cirrhosis can lead to a negative HJR, not positive, due to the liver's decreased size and increased mobility.
**Option B:** This option is likely to be incorrect because conditions like pulmonary embolism can lead to a positive HJR due to increased right ventricular pressure and subsequent increase in jugular venous pressure.
**Option C:** This option is likely to be incorrect because conditions like heart failure with preserved ejection fraction can lead to a positive HJR due to increased diastolic pressure and subsequent increase in jugular venous pressure.
**Clinical Pearl / High-Yield Fact**
Remember that positive HJR is not specific to right heart failure and can be seen in other conditions that increase intrathoracic pressure, such as tricuspid regurgitation or constrictive pericarditis.
**Correct Answer:** C.