Jugular venous pulse (JVP)

Jugular venous pulse (JVP) Assessment of jugular venous pulse has to be done in the internal jugular vein though a beginner is often tempted to use the external jugular vein. External jugular vein may be kinked and it may not reflect the true right atrial pressure. Jugular venous pressure is measured with reference to the sternal angle. The sternal angle is 5 cm above the mid right atrium in all positions. Normal internal jugular venous pulsations are not visible in the neck in the sitting position. Hence it is typically measured with 45 degrees propped up position. But if the venous pressure is elevated, measurement in sitting position is possible. Vertical distance of the upper level of the pulsations above the sternal angle and measured in cm of JVP. Sometimes the JVP may be so high that the upper level may not be visible. It may be visible in standing position in such cases. Pulsations of the ear lobe will be noted in such cases. In cases without visible elevation of JVP, sustained pressure over the upper abdomen for 30 seconds may be given to elicit the abdominojugular or hepatojugular reflux. While examining engorged jugulars, it is important to check whether they are pulsatile or non-pulsatile. Non-pulsatile engorged jugulars suggest superior vena caval obstruction (Superior vena cava syndrome). Respiratory variation of the jugular venous pulsation is another important aspect. Normally the amplitude of the pulsations increase in inspiration while the upper level (jugul...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: HBC abdominojugular reflux cannon waves Friedreich’s sign hepatojugular reflux Superior vena cava syndrome Source Type: blogs