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Jugular Venous Distention

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1. Jugular Venous Distention

Jugular Venous Distention Jugular Venous Distention Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Jugular Venous Distention Jugular (...) Venous Distention Aka: Jugular Venous Distention , Jugular Venous Pulse , Jugular Venous Pulsation , Jugular Venous Pressure , Kussmaul's Sign , JVD , JVP , Hepatojugular Reflux , Abdominojugular Test , HJR From Related Chapters II. Technique: Jugular Venous Pressure measurement Examine position Head of bed elevated at 45 degree angle Head turned to right Identify top of venous pulsation in neck (JVP) Jugular Venous Pulsations are inward Contrast with outward pulsations Identify the sternal angle

2018 FP Notebook

2. <TextConstruct type="text" xmlns="http://www.w3.org/2005/Atom">Jugular venous distention- the physical exam</TextConstruct>

Jugular venous distention- the physical exam Renal Fellow Network: Jugular venous distention- the physical exam | | | | | Sunday, January 2, 2011 Jugular venous distention- the physical exam The physical examination of volume status is perhaps the most common assessment we perform in everyday clinical practice. It is also one of the most difficult and subjective tasks to perform. In particular, the JVP is one (...) pressure. Kussmaul's sign refers to an abnormal response to inspiration, that is a RISE in RA mean and jugular venous pressure said... Cardiologists can estimate the blood pressure in the jugular vein by careful observation of the vein. Subscribe to: Interested in Contributing to the Renal Fellow Network? Email Matt or Gearoid NSMC Founding Member Get notified of new RFN posts by email Partner A nice repository of landmark articles and reviews in the field of nephrology at . are also included. Partner

2011 Renal Fellow Network

3. <TextConstruct type="text" xmlns="http://www.w3.org/2005/Atom">Jugular venous distention- the physical exam, continued...</TextConstruct>

Jugular venous distention- the physical exam, continued... Renal Fellow Network: Jugular venous distention- the physical exam, continued... | | | | | Tuesday, January 4, 2011 Jugular venous distention- the physical exam, continued... Following on from Finnian's last , here are some remarkable videos from the 1950's on JVP examination (physical examination of JVP begins at 3:38): Posted by Conall O' Seaghdha at Labels

2011 Renal Fellow Network

4. Jugular Venous Distention

Jugular Venous Distention Jugular Venous Distention Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Jugular Venous Distention Jugular (...) Venous Distention Aka: Jugular Venous Distention , Jugular Venous Pulse , Jugular Venous Pulsation , Jugular Venous Pressure , Kussmaul's Sign , JVD , JVP , Hepatojugular Reflux , Abdominojugular Test , HJR From Related Chapters II. Technique: Jugular Venous Pressure measurement Examine position Head of bed elevated at 45 degree angle Head turned to right Identify top of venous pulsation in neck (JVP) Jugular Venous Pulsations are inward Contrast with outward pulsations Identify the sternal angle

2015 FP Notebook

5. Diagnosis and Management of Cerebral Venous Thrombosis

of enhanced dural sinus. CTV is at least equivalent to MRV in the diagnosis of CVT. , , , , , However, drawbacks to CTV include concerns about radiation exposure, potential for iodine contrast material allergy, and issues related to use of contrast in the setting of poor renal function. , , , , , , , , , , In some settings, MRV is preferable to CTV because of these concerns ( ). Figure 9. Computed tomographic venogram (axial) showing extension of the cerebral venous thrombosis down to the jugular vein (...) Diagnosis and Management of Cerebral Venous Thrombosis Diagnosis and Management of Cerebral Venous Thrombosis | Stroke Search Hello Guest! Login to your account Email Password Keep me logged in Search April 2019 March 2019 February 2019 February 2019 January 2019 Free Access article Share on Jump to Free Access article Diagnosis and Management of Cerebral Venous Thrombosis A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association , MD, MSc, FAHA

2011 Congress of Neurological Surgeons

6. Correlation of Physical Exam Versus Non-invasive Assessment Versus Invasive Assessment of Central Venous Pressure

). Condition or disease Intervention/treatment Central Venous Pressure Device: Mespere Venus System Procedure: Right heart catheterization (RHC) Procedure: Physical examination of jugular vein Detailed Description: Estimation of volume status is crucial when making treatment decisions for heart failure patients. Volume status is often assessed clinically by estimating the CVP, which is an estimate of right atrial filling pressure, by assessing the level of jugular venous distention. This method is quick (...) -invasive central venous pressure system Procedure: Right heart catheterization (RHC) Invasive procedure to assess CVP. Standard of care. Procedure: Physical examination of jugular vein Physicians assess CVP using the subject's jugular vein. Other Name: Jugular venous pressure (JVP) Outcome Measures Go to Primary Outcome Measures : Central Venous Pressure (CVP) [ Time Frame: 0-3 hours ] To determine if the CVP from the non-invasive monitor correlates with the CVP from the invasive method (via RHC

2012 Clinical Trials

7. Amyloidosis

):749-57. http://www.ncbi.nlm.nih.gov/pubmed/12780789?tool=bestpractice.com History and exam presence of risk factors jugular venous distention lower extremity oedema periorbital purpura macroglossia fatigue weight loss dyspnoea on exertion paraesthesia claudication nausea abdominal cramps alternating bowel habit light-headed/orthostatic hypotension submandibular salivary gland enlargement hepatomegaly shoulder pad sign diffuse muscular weakness sensory neuropathy Tinel's sign Phalen's manoeuvre

2018 BMJ Best Practice

8. CRACKCast E199 – Adult Resuscitation

Prehospital interventions past medical/psychiatric history drug ingestion or environmental exposures? do we need to give an antidote? Allergies Physical Exam: TABLE 8.2 Physical Examination Findings (Rosen’s 9th Edition) PHYSICAL EXAMINATION ABNORMALITIES POTENTIAL CAUSES General Pallor Hemorrhage Cold Hypothermia Airway Secretions, vomitus, or blood Aspiration Airway obstruction Resistance to positive-pressure ventilation Tension pneumothorax Airway obstruction Bronchospasm Neck Jugular venous distention (...) bicarbonate Hemodialysis Hypokalemia Serum Potassium, U waves/prolonged QTc on ECG, history of poor intake or losses Potassium supplementation Acidosis Arterial blood gas Hyperventilation, sodium bicarbonate Treat underlying cause Cardiac Tamponade Echocardiogram; jugular venous distention Pericardiocentesis Thoracotomy and pericardiotomy Toxicity History of drug ingestion Drug-specific Drug-specific Tension Pneumothorax Asymmetric breath sounds, tracheal deviation Needle thoracostomy Tube thoracostomy

2019 CandiEM

9. Patients Hospitalized with Heart Failure: Risk Assessment, Management, and Clinical Trajectory

† Elevated jugular venous pressure Rales‡ Pleural effusion‡ Increased intensity of pulmonary component of second sound Third heart sound Murmurs of mitral and/or tricuspid regurgitation Pulsatile hepatomegaly Ascites§ Pre-sacral, scrotal, or peroneal edema Peripheral edema *Often when supine. †JVP is the most sensitive sign. Rales may not always be present. ‡Not common in chronic HF. §May be dif?cult to distinguish from central adiposity. HF¼ heart failure; JVP¼ jugular venous pressure. JACC VOL

2019 American College of Cardiology

10. Amyloidosis

):749-57. http://www.ncbi.nlm.nih.gov/pubmed/12780789?tool=bestpractice.com History and exam presence of risk factors jugular venous distention lower extremity oedema periorbital purpura macroglossia fatigue weight loss dyspnoea on exertion paraesthesia claudication nausea abdominal cramps alternating bowel habit light-headed/orthostatic hypotension submandibular salivary gland enlargement hepatomegaly shoulder pad sign diffuse muscular weakness sensory neuropathy Tinel's sign Phalen's manoeuvre

2017 BMJ Best Practice

11. Standardized Library of Atrial Fibrillation Outcome Measures

described as unusual dyspnea on light exertion, recurrent dyspnea occurring in the supine position, fluid retention; or the description of rales, jugular venous distention, or pulmonary edema on physical examination. A low ejection fraction without clinical presentation does not qualify as heart failure. Studies that wish to classify heart failure should use the New York Heart Association (NYHA) Functional Classification. 2013 ACCF/AHA key data elements and definitions (9) Events of Interest Other major

2018 Effective Health Care Program (AHRQ)

12. Spotlight: Subacute Endocarditis: The Great Masquerader

, jugular venous distention was not present, and the patient was noted to have a regular rate and rhythm with normal S1/S2 but a harsh 2/4 short diastolic murmur. There were decreased breath sounds at the lung bases without bilateral lower extremity edema. A transthoracic echocardiogram revealed severe aortic insufficiency due to a 1.5cm aortic vegetation. He was treated with IV penicillin and gentamicin for two weeks followed by one month of ceftriaxone. He underwent aortic valve replacement given

2017 Clinical Correlations

15. Guidelines for the Appropriate Use of Bedside General and Cardiac Ultrasonography in the Evaluation of Critically Ill Patients

recommend that BCU should be performed to diagnose cardiac tamponade and to increase the effectiveness and safety of pericardiocentesis and guide performance of the procedure. Grade 1B Rationale: Classic physical examination findings of cardiac tamponade such as jugular venous distention, hypotension, and diminished heart sounds are usually absent ( ); furthermore, symptoms of pericardial effusion/early tamponade are absent or mistaken for congestive heart failure ( ). BCU can successfully identify (...) should be considered preload responsive. Patients with a smaller change in IVC diameter may not respond favorably to fluid resuscitation. Grade 1B Rationale : Recent data have suggested that central venous pressure (CVP) does not correlate with fluid responsiveness ( , ). In addition, overly aggressive crystalloid-based resuscitation may result in untoward outcomes ( ). Echocardiographic functional or dynamic assessments of fluid responsiveness can be performed on the venous or arterial side. Venous

2016 Society of Critical Care Medicine

16. Utility of the Cardiovascular Physical Examination and Impact of Spironolactone in Heart Failure With Preserved Ejection Fraction. (PubMed)

Utility of the Cardiovascular Physical Examination and Impact of Spironolactone in Heart Failure With Preserved Ejection Fraction. The prognostic value of physical examination, its relation to quality of life, and influence of therapy in heart failure with preserved ejection fraction is not well known.We studied participants from the Americas with available physical examination (jugular venous distention, rales, and edema) at baseline in the TOPCAT trial (Treatment of Preserved Cardiac Function (...) Questionnaire overall summary scores and to outcomes. Among 1644 participants, 22%, 54%, 20%, and 4% had 0, 1, 2, and 3 signs of congestion, respectively, at baseline. After multivariable adjustment, each additional increase in sign of congestion was associated with a 30% to 60% increased risk of each outcome ( P<0.001). Spironolactone reduced the total number of signs of congestion by -0.10 ( P=0.005) signs, jugular venous distention (odds ratio, 0.60; P=0.01), and edema (odds ratio, 0.74; P=0.006) at 4

2019 Circulation. Heart failure

17. Type A aortic dissection associated with tension pneumothorax. (PubMed)

-old man presented to the emergency department with sudden-onset chest and back pain. Upon presentation, his blood pressure was 97/58 mmHg, oxygen saturation on room air was 96%, and respiratory rate was 28 breaths/min. His physical examination revealed no jugular venous distention; however, breath sounds over the left lung were diminished. Bedside chest radiography revealed left tension pneumothorax with mediastinal shift to the right. Needle and chest tube thoracostomies were performed; however

2019 American Journal of Emergency Medicine

18. Prognostic Implications of Congestion on Physical Examination Among Contemporary Patients with Heart Failure and Reduced Ejection Fraction:PARADIGM-HF. (PubMed)

follow up with quality of life (QoL) and clinical outcomes and to assess the treatment effects of sacubitril/valsartan on congestion. Methods: We analyzed participants from PARADIGM-HF (Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor With Angiotensin Converting Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in HF) with an available physical examination at baseline. We examined the association of the number of signs of congestion (jugular venous distention

2019 Circulation

19. Congenital Heart Disease in the Older Adult

and may require specialized mapping for ablation. Vascular complications include the development of pulmonary hypertension, aortic root dilation, aneurysm formation, and venous insufficiency. Importantly, with age, and in this older ACHD population, management will need to encompass acquired heart disease. In the general population, mortality rates for all cardiovascular disease, coronary heart disease, and stroke are, respectively, 10, 9, and 13 times higher in people ≥65 years old than in those 45 (...) aortic cusp prolapse after VSD repair (or in unrepaired restrictive VSD) with aortic insufficiency and, rarely, development of a subaortic membrane or right ventricular (RV) muscle bundle hypertrophy and a double-chambered RV. Electrophysiological concerns late in life can include IART after ASD closure or patch repair for partial anomalous pulmonary venous return and sinus venosus atrial defect. Sick sinus syndrome or low atrial rhythms can also be seen late after sinus venosus and anomalous

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2015 American Heart Association

20. Heart Failure Management in Skilled Nursing Facilities

of the time and are integral to detect changes in condition. Unlicensed CNA staff must work closely with the licensed staff (RN and LPN) to report changes in condition so that licensed staff assesses jugular venous distention, edema, and lung sounds. Jugular venous distention is the most important examination for volume status ( ). Appendix 3 provides a detailed description of jugular venous pressure assessment. To support quality of care, all licensed staff must be educated on jugular venous distention (...) . Estimation of jugular venous pressure in different positions. EJV indicates external jugular vein; JVP, jugular venous pressure; RA, right atrium; and SA, sternal angle. Reprinted from Ahmed et al with permission from American Medical Directors Association. Copyright © 2008, American Medical Directors Association. The frequency of assessments of weight, signs and symptoms, fluid management, and vital signs has not been standardized in SNFs, and these assessments are primarily delegated to the CNA

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2015 American Heart Association

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