What does jugular vein pressure tell us about volume status?

Jugular venous pressure (JVP) estimation is a non-invasive approach to assessing a patient’s volume status. It is used to evaluate whether right atrial pressure (RAP) is high or normal and to evaluate trends in RAP, including response to treatment.

When assessing the guts, you’ll deal with the pulsation of the interior jugular vein on the patient’s right side to take a measurement. (Learn the JVP measurement technique in our Pocket Cardiac Assessment Card.) Normal venous pressure is between 1 and eight mmHg, so although a low value may indicate volume loss, it will not be diagnostic because it will probably even be a standard symptom.

Elevated JVP

JVP measured at a distance greater than 3 cm above the sternal angle or greater than 8 cm in the whole distance above the fitting atrium is taken into account (Bickley et al., 2021).

Heart failure (HF) is the leading reason for increased pressure in the fitting heart, so assessing JVP will help diagnose HF or detect exacerbations. Elevated JVP can also be a vital think about the diagnosis or treatment of other disorders reminiscent of superior vena cava obstruction, tricuspid valve disease, pericardial disease, chronic pulmonary hypertension, and cardiac tamponade (Bickley et al., 2021; Meyer, 2021).

Remember…

• JVP is an index of RAP and provides a direct measure of left ventricular filling pressure. Abnormal results ought to be interpreted together with other results.
• In obstructive pulmonary disease, JVP could also be elevated on expiration, however the veins collapse on inspiration. This doesn’t mean heart failure.

Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bate’s guide to physical examination and history taking (thirteenth ed.). Wolters Kluwer Health: Philadelphia.

Meyer, T. (2021, December 3). Examination of the jugular venous pulse. https://www.uptodate.com/contents/examination-of-the-jugular-venous-pulse