What is jugular vein distention?
The jugular veins carry blood from the head to the superior vena cava (the main vein of the upper body), which empties into the heart. The external jugular vein is closest to the skin and can sometimes be seen as a rope-like bulge on the side of the neck. Bulging of the external jugular vein is known as jugular vein distention.
The height of the bulge measured from the top of the clavicle, or collar bone, is an indirect indicator of the central venous pressure, the pressure in the right atrium (the heart chamber that receives blood returning from the body).
Jugular vein distention is affected by the position of your body. If the height is greater than 3 to 4 centimeters when measured while you are in bed with your head elevated 45 degrees, this may signal vascular or heart disease. Smaller amounts of jugular vein distention can occur in people without heart or vascular disease.
Increased blood volume, which can occur with heart failure, or anything that interferes with filling of the right atrium or movement of the blood into the right ventricle, can increase the central venous pressure and the amount of jugular vein distention. For example, jugular vein distention may be raised by a narrowing or blockage of the superior vena cava, which can interfere with blood return to the heart. It can also be caused by constrictive pericarditis (infection of the lining that surrounds the heart) and cardiac tamponade (filling of the sac around the heart with blood or other fluid), both of which restrict the volume of the heart. Right-sided heart failure is another cause of elevated jugular vein distention.
Jugular vein distention can accompany serious vascular and heart conditions. Seek immediate medical care (call 911) for chest pain or pressure, shortness of breath, pale skin or pallor, bluish coloration of the lips or fingernails, profuse sweating, difficulty breathing or rapid breathing (tachypnea), rapid heart rate (tachycardia), increasing fatigue or weakness (loss of strength), or change in level of consciousness.
If your jugular vein distention is persistent, worsens, or otherwise causes you concern, seek prompt medical care.
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- Techniques: jugular venous pressure measurement (JVP). University of Washington Department of Medicine. http://depts.washington.edu/physdx/neck/tech1.html
- Measuring central venous pressure with a triple-lumen catheter. American Association of Critical-Care Nurses. http://ccn.aacnjournals.org/content/32/3/62.full