The most common error in assessing the jugular venous pressure, even for experienced observers, is to mistake the venous for the carotid arterial pulse. The following hints help identify the venous pulse:
It varies with respiration, normally falling with inspiration and rising with expiration.
It is easily obliterated by gentle finger pressure at the base of the neck.
It is amplified, especially when pressure is elevated, by gentle pressure over the abdomen (hepatojugular reflux).
Multiple waveforms are seen in contrast to the single carotid beat.
Bruns DL: A general theory of the causes of murmurs in the cardiovascular system. Am J Med 27:360-374,
Craige E: Gallop rhythm. Prog Cardiovasc Dis 10: 246, 1967.
Leatham A: Auscultation of the heart.
Photo Gallery of How Is The Venous Jugular Pulse Differentiated From The Carotid Arterial Pulse?
Click to on Photo for Next How Is The Venous Jugular Pulse Differentiated From The Carotid Arterial Pulse? Images
Leathan A: The second heart sound: Key to auscultation of the heart. Acta Cardiol 19: 395, 1964.
Lembo NJ, Dell'Italia LJ, Crawford MH, O'Rourke RA: Bedside diagnosis of systolic murmurs. N Engl J
Med 318: 1572, 1988.
Patel R, Bushnell DL, Sobotka PA: Implications of an audible third heart sound in evaluating cardiac function. West J Med 158: 606-609, 1993.
Perloff JK: Physical Examination of the Heart and Circulation. Philadelphia, W.B. Saunders, 1990.
Ravin A, Craddock LD, Wolf PS, Shander D: Auscultation of the Heart. Chicago, Year Book, 1977.