Evidence Base - Neck Veins

Cardiac Hemodynamics

The following tables and graph depict the correlation of bedside-measured jugular venous pressure (JVP) with cardiac catheterization hemodynamics in patient with chronic congestive heart failure. The pulmonary capillary wedge pressure (PCWP) is considered elevated if >18 mm Hg, and is a sign of fluid overload. Elevated JVP is referred to as jugular venous distention (JVD).

Jugular Venous Distention and Pulmonary Capillary Wedge Pressure

Sensitivity of JVD PCWP >18 mm Hg	57%
Specificity of -JVD PCWP <18 mm Hg	93%
Positive Predictive Value of JVD	95%
Negative Predictive Value of JVD	47%

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Jugular Venous Distention, Hepatojugular Reflux (HJR), and Pulmonary Capillary Wedge Pressure

Sensitivity of JVD PCWP >18 mm Hg	81%
Specificity of -JVD PCWP <18 mm Hg	80%
Positive Predictive Value of JVD	91%
Negative Predictive Value of JVD	63%

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PCWP in Relation to Clinical Findings of JVD and HJR

Patients without JVD and with negative HJR Patients without JVD but with positive HJR Patients with both JVD and positive HJR

Adapted from Butman, et al

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