Physical examination maneuver
Physical Exam
Jugular Venous Pressure
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Video coming soon
How to Perform
With the patient reclining initially at about 30° to 45° and the head turned slightly away, identify the right internal jugular venous pulsation. Adjust the degree of recline as needed until the top of the venous pulsation is visible in the neck. Place a ruler vertically at the sternal angle. Hold a second ruler or other straightedge horizontally from the top of the venous pulsation, keeping it parallel to the floor, until it intersects the vertical ruler. Measure the vertical distance above the sternal angle in centimeters.
How to Interpret
Showing 9 of 24 findings
Elevated Pulmonary Capillary Wedge Pressure
Positive abdominojugular (hepatojugular) reflux
Rule in
Somewhat helpfulDerived CI
Rule out
InconclusiveWide CI
Evidence:Moderate
Jugular venous distension at rest or induced by abdominal pressure
Rule in
Somewhat helpfulNo CI
Rule out
Somewhat helpfulNo CI
Evidence:Moderate
Pulmonary Hypertension
Elevated jugular venous pressure (>3 cm above the sternal angle)
Rule in
Somewhat helpfulNo CI
Rule out
Somewhat helpfulNo CI
Evidence:Moderate
Reduced Left Ventricular Ejection Fraction
Elevated jugular venous pressure
Rule in
Somewhat helpfulNo CI
Rule out
Not helpful
Evidence:Strong
Right Ventricular Infarction
Kussmaul sign (paradoxical rise in JVP on inspiration)
Rule in
Helpful
Rule out
HelpfulWide CI
Evidence:Strong
Elevated jugular venous pressure (>3 cm above the sternal angle)
Rule in
Somewhat helpfulDerived CI
Rule out
InconclusiveWide CI
Evidence:ModerateResearch in progress
Shock
Elevated neck veins and crackles in a hypotensive patient
Rule in
Very helpfulWide CI
Rule out
Somewhat helpfulWide CI
Evidence:Moderate
Elevated neck veins (jugular venous pressure >7 cm H2O) in a hypotensive patient
Rule in
Somewhat helpfulWide CI
Rule out
Somewhat helpfulWide CI
Evidence:Moderate
Volume Overload
Elevated jugular venous pressure (estimated CVP at least 10 cm H2O)
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Moderate
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aka Pulse oximetry
Rule in:HMortality, SHPneumonia, MHCardiac Tamponade +8 more
Rule out:ICCardiac Tamponade, NHHepatopulmonary Syndrome, NHMortality +8 more
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Rule in:HAortic Stenosis, HTakayasu Arteritis, IEAcute Aortic Dissection +9 more
Rule out:SHAortic Stenosis, NHTakayasu Arteritis, IEAcute Aortic Dissection +9 more
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Rule in:SHAtrial Fibrillation, SHDecompensation, SHHypothyroidism +15 more
Rule out:HDecompensation, SHAtrial Fibrillation, SHPostoperative Complication +15 more
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Rule in:VHAortic Stenosis, VHHypertrophic Cardiomyopathy, VHLeft Ventricular Dilation +14 more
Rule out:VHAortic Stenosis, VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy +14 more