discrimination of the JVP from the carotid pulse

Last reviewed 01/2018

The JVP can be discriminated from the carotid pulse because:

  • it cannot be palpated

  • it has a complex wave form; it is usually seen to flicker twice within each cardiac cycle

  • it moves on respiration, normally decreasing on inspiration and rising on expiration; for exceptions, see Kussmaul's sign

  • mild pressure applied to the base of the neck overlying the proximal part of the internal jugular vein will break the column of blood in it, and obliterate its pulsations

  • mild pressure applied over the liver will expel more blood into the right side of the heart and elevate the JVP, a positive hepato-jugular reflex