Indication:

• HF - Heart Failure
• PH - Pulmonary hypertension

Jugular venous pressure + Hepatojugular reflex

Reporting

X cm above the sternal angle, normal/abnormal hepatojugular reflex

Test Character:

• Measure of right heart function and volume status
  • Not for children < 506 : used hepatomegaly and facial edema
• Specific test → Followed up by US of IVC diameter
  • Is it VERY abnormal?
• Elevated in
  • HF
  • Volume Overload
  • Constrictive Pericarditis
  • Cardiac Tampenode
• Depression in
  • ECFVD - Volume depletion
  • Dehydration
  • !Shock (consistent finding)

Position:

• Bed 30 deg. elevated
  • CHF: higher for venous insufficiency - 45, 90
• Relaxed, head tilted slight to the left

Action:

1. Ask the patient to lift their head or push against your palm (while turning the head left) to ID the 2 heads of SCM
   • Look between the sternal head and clavicular head

1. Good lighting (flash light)

   

2. Look for the pulsation of the skin (the waveform), distinguish from carotid using POLICE

   	JVP	Carotid pulse
   Palpable	No	Yes
   Waveform	2	1
   Occlusion by light pressure above clavicle	Yes	No
   Changed by inspiration and body position	Yes (decrease)	No