What is JVD (jugular vein distention)?
Jugular vein distention (JVD) occurs when the pressure inside the vena cava, a large vein that carries deoxygenated blood back to the heart, causes a bulging neck vein. The internal jugular vein and external jugular vein run down both sides of your neck. Bulging of these two jugular veins may be accompanied by pain or discomfort.
How is jugular venous pressure (JVP) evaluated?
Evaluation of jugular venous pressure (JVP) involves observing the patient’s jugular vein in the patient’s neck in varying degrees of positions and maneuvers and estimating right atrial pressure and determining abnormalities in the jugular venous column. Position:
What does it mean when your JVD is elevated?
These are large veins that drain blood from the head and return it directly to the heart. Since they’re located near the surface, they provide a reasonably good measure of systemic venous pressure. JVD is elevated any time venous return is greater than the heart’s ability to pump the blood back out.
How does the internal jugular vein (IJV) work?
This is possible because the internal jugular vein (IJV) connects to the right atrium without any intervening valves, resulting in a continuous column of blood. The presence of this continuous column of blood means that changes in right atrial pressure are reflected in the IJV (e.g. raised right atrial pressure results in distension of the IJV).
What causes JVD?
The most common underlying cause of JVD is heart failure. A person’s outlook depends on how early this is diagnosed, the extent of the damage, their overall health, and how well they respond to treatment.
How to treat JVD?
Treatments include: changes in lifestyle and diet. beta-blockers to decrease the activity of the heart and lower blood pressure.
What is superior vena cava obstruction?
Superior vena cava obstruction can occur if a tumor growing in the chest or a clot in the superior vena cava restricts blood flow in the vein. Constrictive pericarditis.
What is the name of the vein that is bulging on the right side of the neck?
The blood flow from the head to the heart is measured by central venous pressure or CVP. Jugular vein distention or JVD is when the increased pressure of the superior vena cava causes the jugular vein to bulge, making it most visible on the right side of a person’s neck.
What is jugular vein distention?
Jugular vein distention is when a vein on the side of the neck appears to bulge. Image credit: Ferencga, (2003, June 25) A person has jugular veins on both sides of their neck. They act as passageways for blood to move from a person’s head to the superior vena cava, which is the largest vein in the upper body.
What does it mean when your CVP is higher than normal?
If the CVP is higher than normal, it may indicate heart failure or that there is high pressure in the lungs that is affecting the right side of the heart. A doctor will ask about other symptoms, such as chest pain and shortness of breath to help make a diagnosis.
What are the risk factors for JVD?
While heart failure can happen to anyone, risk factors for heart failure include: high blood pressure. congenital heart defects.
Right-Sided Heart Failure
In the United States, 6.2 million adults have heart failure. 1 Left-sided heart failure is more prevalent, and it can eventually lead to right-sided heart failure.
Tension Pneumothorax
A pneumothorax is a collapsed lung, which can happen when air collects between your lungs and chest wall, called the pleural space, and cannot escape. A pneumothorax can be a complete or partial lung collapse.
Pulmonary Hypertension
Pulmonary hypertension is when the pressure of blood in the vessels between the heart and lungs is too high. The pulmonary artery is the blood vessel that carries blood from the heart's right ventricle to the lungs. When pressure increases there, pulmonary hypertension occurs.
Tricuspid Valve Stenosis
The tricuspid valve is between the right atrium and the right ventricle of the heart. Tricuspid valve stenosis is one of four types of tricuspid valve diseases. In tricuspid valve stenosis, there is a narrowing of the valve opening, restricting blood flow between the upper and lower parts of the right side of the heart. 2
Superior Vena Cava Obstruction
The superior vena cava is one of the main veins in the body. It transports blood from your arms, chest, neck, and head to your heart. The jugular vein is one of several veins of the neck that connect to the superior vena cava. When there is an obstruction in the superior vena cava, it becomes compressed or blocked.
Constrictive Pericarditis
Constrictive pericarditis is a chronic condition in which the pericardium, the membrane around the heart, becomes stiff and inelastic. Due to the loss of elasticity in the pericardium, also called the pericardial sac, cardiac function is negatively impacted, leading to symptoms that gradually worsen.
Cardiac Tamponade
Cardiac tamponade is a medical emergency. In this condition, blood and fluid accumulate in the pericardial sac and compress the heart. When this happens, cardiac output is stunted and can also lead to shock, a sudden drop in blood flow throughout the body.
What is JVD in a syringe?
JVD is simply the visible “bulging” of the external jugular veins on either side of the neck. These are large veins that drain blood from the head and return it directly to the heart. Since they’re located near the surface, they provide a reasonably good measure of systemic venous pressure.
What causes JVD?
JVD is therefore caused by right heart failure. (Of course, the most common cause of right heart failure is left heart failure, so that doesn’t mean it’s an isolated event.) If JVD isn’t the heart’s fault, then we look to fluid levels.
Why is JVD harped on in EMS?
Although it’s probably most often seen, and most diagnostic, in volume-overloaded CHF patients, the main reason JVD is harped upon in EMS is because it’s a useful sign of several acute emergencies.
Which is better, the right or the left jugular?
Strictly speaking, the internal jugular is usually considered more diagnostically useful than the external jugular, but it’s far harder to examine, so the latter is often used. For various reasons, many people also find the right jugular more useful than the left, although in an ambulance it’s harder to examine.
What is the difference between the venous pulsation of the JVP and the arterial pulsation
Differences between the venous pulsation of the JVP and the arterial pulsation of the carotid artery include: Number of pulses: the JVP has a double waveform pulse (i.e. 2 pulses) whereas the carotid artery has a single pulsation for each cardiac cycle.
Where is the IJV located?
The IJV runs between the medial end of the clavicle and the ear lobe, under the medial aspect of the sternocleidomastoid, making it difficult to visualise (its double waveform pulsation is, however, sometimes visible due to transmission through the sternocleidomastoid muscle). Because of the inability to easily visualise the IJV, ...
What happens during the second part of the X descent?
The second part of the X descent occurs during the final phase of right ventricular contraction. When the ventricle reaches its most contracted state, it is physically much smaller than when in its relaxed state, resulting in the creation of extra space within the pericardium. This extra space within the pericardium allows the right atrium to expand and begin filling with blood. This initial phase of atrial filling results in a drop in venous pressure within the SVC and IVC, producing the second part of the X descent.
What is the function of the jugular vein?
Jugular venous pressure (JVP) provides an indirect measure of central venous pressure. This is possible because the internal jugular vein (IJV) connects to the right atrium without any intervening valves, resulting in a continuous column of blood. The presence of this continuous column of blood means that changes in right atrial pressure are reflected in the IJV (e.g. raised right atrial pressure results in distension of the IJV).
Why use the external jugular vein?
Because of the inability to easily visualise the IJV, it’s tempting to use the external jugular vein (EJV) as a proxy for assessment of central venous pressure during clinical assessment. However, because the EJV typically branches at a right angle from the subclavian vein (unlike the IJV which sits in a straight line above the right atrium) ...
What is a hepatojugular reflux test?
The hepatojugular reflux test involves the application of pressure to the liver whilst observing for a sustained rise in JVP. This test can be used to further assess the JVP, particularly if you are unsure if the vessel you are observing is the internal jugular vein.
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Part one of our two part special on diabetes focuses on the firsthand experience of a patient living with diabetes. We discuss what it is like to be diagnosed with Type 1 diabetes and to live with and manage the condition day-to-day. We hope that this episode will be useful for students, medical professionals, and anyone who wants to understand more about the challenges of managing this condition. Guest: Ashwin Bali