JVD (Jugular Venous Distension)
Formal Definition
Visible distension of the external or internal jugular veins at 45 degrees of head-of-bed elevation, reflecting elevated right atrial pressure and serving as a bedside estimate of central venous pressure; abnormal when >4 cm above the sternal angle.
How It's Used on the Ward
"JVD" or "elevated JVP" — a key physical exam finding in right heart failure, tamponade, tension pneumothorax, and fluid overload.
Example
""Patient with known systolic HF presenting with 10-lb weight gain over 3 days: JVD to the earlobe at 45 degrees, 3+ edema, S3 on exam. Classic decompensation — diuresing aggressively.""
Clinical Context
JVD suggests either right heart failure, biventricular failure, constrictive pericarditis, cardiac tamponade, or SVC obstruction. Absent in distributive shock (sepsis, anaphylaxis) where the problem is vasoplegia, not volume overload — useful clinical discriminator. In tamponade: Beck's triad = hypotension + JVD + muffled heart sounds. JVD is best assessed with patient at 30–45 degrees, head turned left, lighting tangential.
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