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Deteriorating Patient

Jugular Venous Pressure (JVP)



    • Look For

    • The pulsation of the jugular vein, between the sternal and clavicular heads of the sternocleidomastoid.
    • How to Perform

    • Position the patient at 45 degrees and ask them to turn their head to the left. Hold a flashlight tangentially to the skin of the neck and inspect for the highest level of the jugular venous pulsation. Measure the vertical distance between the sternal angle and this level.
    • Interpretation

    • The JVP is elevated if the vertical distance between the sternal angle and the highest point of the pulse is greater than 3cm.
    • Causes of Elevated JVP

    • Fluid overload - excessive IV fluids, renal disease, heart failure
    • Right ventricular systolic failure - cor pulmonale, left ventricular failure
    • Right ventricular diastolic failure - constrictive pericarditis, tamponade
    • Pulmonary hypertension
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