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.
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