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Deborah J. Cook, MD, FRCPC, MSc (Epid); David L. Simel, MD, MHS

JAMA. 1996;275(8):630-634.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

A 65-YEAR-OLD woman has had dyspnea for 2 months. She has had to give up her hobby of hiking and is now short of breath climbing even one flight of stairs. Her dyspnea is sometimes worse at night. She has no chest pain, cough, or sputum, and the review of systems is otherwise negative. On physical examination, her blood pressure is 135/90 mm Hg, and she has a regular cardiac rhythm at a rate of 72 beats per minute. You turn your attention to the jugular veins and next ask yourself, "Does this patient have abnormal central venous pressure?"

WHY IS THIS QUESTION IMPORTANT?

Evaluation of the jugular venous pulse provides important information about pressure and other hemodynamic events in the right atrium.^1-3 Via the former, it provides a useful estimate of central venous pressure (CVP) and thus the patient's intravascular volume status. Inspection of the waveforms can assist . . . [Full Text PDF of this Article]

Author Affiliations
From the Departments of Medicine and Clinical Epidemiology and Biostatistics, McMaster University Faculty of Health Sciences, Hamilton, Ontario (Dr Cook); and The Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Duke University Medical Center, Durham, NC (Dr Simel). Dr Cook is a Career Scientist of the Ontario Ministry of Health.

Footnotes
Reprint requests to Department of Medicine, Division of Critical Care, St Joseph's Hospital, 50 Charlton Ave E, Hamilton, Ontario, Canada L8N 4A6 (Dr Cook).

The Rational Clinical Examination section editors: David L. Simel, MD, MHS, Durham Veterans Affairs Medical Center and Duke University Medical Center, Durham, NC; Drummond Rennie, MD, Deputy Editor (West), JAMA.

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