Jugular Venous Distention (JVD)
Jugular venous distention indicates increased right atrial pressure. The Jugular venous pressure (JVP) is measured clinically by the distance from the sternal notch to the top oscillating visible pulsations on the vein (Internal preferred over the External jugular vein) plus 5 cm. Ask the patient to turn his head to the opposite side of which you are standing at with the upper body preferably elevated at the hip by 35-45 degrees. If venous pulsations seen at the clavicle, it means an elevated JVP. This abnormality is called Kussmaul's sign. The normal JVP is 1-8 cm of H2O which means about 3 cm above the sternal notch (angle of Louis).
Causes of Jugular Venous Distention (JVD):
- Cardiac tamponade
- Congestive heart failure
- Constrictive pericarditis
- Cor pulmonale
- Massive pulmonary embolism
- Pericardial effusion
- Pulmonary hypertension
- Right/left heart failure
- Severe tricuspid regurgitation
- Superior vena cava obstruction
- Tricuspid stenosis
Interesting read on cardiac exam is Cardiac physical exam.
This post covers the points you need to know for your board exams as well as for teaching residents on the daily rounds. Medical professionals can't use the information here to treat their patients nor people can use the information her to treat themselves. If you are having any medical issues, contact your local emergency services. Please refer to your doctor for medical advice.