jugular venous pressure

Well, on cardiac exam, he has regular rate and rhythm, no murmurs, no rubs.

His JVP is not elevated.

He has no peripheral edema.

However, on lung exam, you notice that his breathing overall is unlabored, but you notice crackles at the left base that sound like Velcro opening.

Right-sided findings can be particularly prominent.

You may see elevated JVP, peripheral edema, hepatomegaly, and a positive cosmole sign.

And because both atria are exposed to chronically elevated filling pressures, biatrial enlargement is a classic clue.

The ECG can provide additional clues depending on the cause.

Think of it as the heart trying to fill inside a rigid box.

Patients typically present with symptoms and signs of right-sided heart failure, peripheral edema, ascites, elevated JVP, hepatomegaly, and sometimes exercise intolerance and dyspnea.

A particularly useful bedside clue is elevated JVP with a prominent respiratory pattern.

You can also see the Kussmaul sign, where the JVP rises or fails to fall during inspiration.

The underlying causes include prior pericarditis, tuberculosis, cardiac surgery, radiation, malignancy, and other inflammatory or infectious processes.

Sometimes no specific cause is identified.

I'll talk about the jugular vein or pocus of jugular vein to start with.

As I conceptualize this, the use of pocus at the bedside, looking for the ultrasound jugular venous distension or ultrasound jugular venous pressure is essentially an aided or a direct way to visualize that meniscus that you're looking for on surface anatomy.

And it really allows for the assessment of the JVP in a wider variety of body types, more so than visual inspection.

There's a variety of techniques.

And one thing to talk about initially is just that they're different probes.