Jugular venous pressure

[citation needed] Pulses in the JVP are rather hard to observe, but trained cardiologists do try to discern these as signs of the state of the right atrium.

The JVP and carotid pulse can be differentiated several ways:[citation needed] The jugular venous pulsation has a biphasic waveform.

[citation needed] In a prospective randomized study involving 86 patients who underwent right and left cardiac catheterization, the abdominojugular test was shown to correlate best with the pulmonary arterial wedge pressure.

[5] The abdominojugular test, when done in a standardized fashion, correlates best with the pulmonary arterial wedge pressure, and therefore, is probably a reflection of an increased central blood volume.

The study also found that agreement between doctors on the jugular venous pressure can be poor, calling into question its reliability as a clinical decision-making tool.

[citation needed] The paradoxical increase of the JVP with inspiration (instead of the expected decrease) is referred to as the Kussmaul sign, and indicates impaired filling of the right ventricle.

The differential diagnosis of Kussmaul's sign includes constrictive pericarditis, restrictive cardiomyopathy, pericardial effusion, and severe right-sided heart failure.

A man with congestive heart failure and marked jugular venous distention. External jugular vein marked by an arrow; however, JVP is not measured by looking at the external jugular vein even but is instead measured by pulsations of the skin from the internal jugular vein, which is not visible in this image.
The veins of the neck, viewed from in front.
A JVP waveform