jugular venous pressure

Jugular venous pressure, or JVP, is the height to which blood stands in the large veins of the neck — a bedside window onto the pressure inside the right side of the heart. The neck veins connect to the right atrium through an almost unobstructed channel, so the level at which the vein visibly pulsates acts like the water level in a standpipe, showing how full and how pressured the venous side of the circulation is.

To read it, the clinician seats the patient reclined at about 45 degrees, finds the soft, undulating pulsation of the internal jugular vein in the neck, and measures how many centimeters above the sternal angle it rises. A normal JVP is low; a raised JVP means blood is backing up, as happens in right-sided heart failure, fluid overload, or conditions that impede filling of the right heart such as cardiac tamponade or constrictive pericarditis.

Beyond simple height, the JVP has a delicate waveform whose rises and falls correspond to events in the cardiac cycle, and certain abnormalities — giant waves, an absent fall, or a rise on inspiration — point to specific diagnoses. It is a skilled examination that takes practice, and it complements rather than replaces imaging and pressure measurements.