1. What is JVP?
- JVP is the indirect
measurement of pressure in the right atrium of the heart.
- Reflected
as a wave-like pulsation seen in the internal jugular vein
(IJV).
- Best
observed at the right side of the neck (right IJV directly connects
to right atrium).
2. Why is JVP
Important?
- Gives
information about right atrial pressure, central venous pressure
(CVP), and cardiac function.
- Helps
diagnose heart failure, tricuspid valve disease, constrictive
pericarditis, etc.
3. Anatomical Basis
- Internal
Jugular Vein (IJV) lies between the sternocleidomastoid
muscle and trachea.
- No valves
between IJV and right atrium, so pressure changes reflect directly in the
vein.
4. Normal JVP
- Measured
by elevating the patient’s head at 45°.
- Normal
height: ≤ 3–4 cm above the sternal angle or ≤ 8–9 cm above the
right atrium.
5. JVP Waveform –
Components
|
Wave/Descent |
Meaning |
Cause |
|
a wave |
Atrial contraction |
Just before S₁ |
|
c wave |
Bulging of tricuspid valve into RA during ventricular systole |
Isovolumetric contraction |
|
x descent |
Atrial relaxation and downward displacement of tricuspid valve |
During ventricular systole |
|
v wave |
Venous filling of RA against closed tricuspid valve |
End of systole |
|
y descent |
Rapid emptying of RA into RV |
After tricuspid valve opens |
Mnemonic for wave order: "a - c - x - v -
y"
6. How to Examine JVP
- Position
patient at 45° angle.
- Observe right
IJV (between two heads of SCM).
- Use sternal
angle as a reference point.
- Measure
vertical height of pulsation from sternal angle.
7. Differences Between
JVP & Carotid Pulse
|
Feature |
JVP |
Carotid Pulse |
|
Palpable |
No |
Yes |
|
Character |
Biphasic |
Monophasic |
|
Affected by respiration |
Yes |
No |
|
Position dependent |
Yes |
No |
8. Clinical Conditions
Showing Raised JVP
- Right
heart failure
- Constrictive
pericarditis
- Tricuspid
regurgitation (giant v wave)
- Cardiac
tamponade
- Superior vena cava obstruction (non-pulsatile)
