Physical examination maneuver
Physical Exam
Jugular Venous Pressure
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Video coming September 2026
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 8 of 24 findings
Elevated Pulmonary Capillary Wedge Pressure
Positive abdominojugular (hepatojugular) reflux
Rule in
Somewhat helpfulDerived CI
Rule out
InconclusiveWide CI
Evidence:Limited
Jugular venous distension at rest or induced by abdominal pressure
Rule in
Somewhat helpfulNo CI
Rule out
Somewhat helpfulNo CI
Evidence:Limited
Heart Failure
Elevated jugular venous pressure (>3 cm above the sternal angle)
Rule in
Helpful
Rule out
Minimally helpful
Evidence:Strong
Pulmonary Hypertension
Elevated jugular venous pressure (>3 cm above the sternal angle)
Rule in
Somewhat helpful
Rule out
Somewhat helpful
Evidence:Limited
Right Ventricular Infarction
Kussmaul sign (paradoxical rise in JVP on inspiration)
Rule in
Helpful
Rule out
Helpful
Evidence:Strong
Elevated jugular venous pressure (>3 cm above the sternal angle)
Rule in
Somewhat helpfulDerived CI
Rule out
InconclusiveWide CI
Evidence:Limited
Shock
Elevated neck veins (jugular venous pressure >7 cm H2O) in a hypotensive patient
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Limited
Volume Overload
Elevated jugular venous pressure (estimated CVP at least 10 cm H2O)
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Limited