We are talking about a sign that appears when there is an increase in venous pressure in the superior cava system.
Jugular engorgement or pressure is the increase in volume (lump) and consistency of this vein caused by an accumulation of blood .
Then we speak of jugular venous distention, which is defined by the bulging of the internal jugular vein more than 5 cm above the sternal angle at 45 degrees.
Brief information on the function and anatomy of the jugular vein
The internal jugular vein is an important blood vessel that drains blood from organs and important parts of the body, such as the brain , face, and neck.
Anatomically, there are two of these veins found along each side of the neck. Each rests next to the thyroid gland in the center of the neck, just above the collarbone and near the windpipe.
These veins work to transport oxygen-depleted blood from the brain, face, and neck, and transport it to the heart through the superior vena cava.
In general, the left vein is somewhat smaller and thinner than the right, but both contain valves that help transport blood. The vein appears dilated (wider) in two points, and these different parts are called the upper bulb and lower bulb.
The vein plays an important role in evaluating jugular vein pressure, especially in people with heart disorders.
Jugular vein pressure measurements are used to assess central venous pressure , which indicates how much blood is returning to the heart and how well the blood is pumping through the arteries.
Because this vein is also larger than most others, it is commonly used as an entry point for placing venous lines, which are tubes (catheters) used to transport drugs or nutrients to the body.
Distention (engorgement) is a condition that can affect this vein.
What is jugular vein strain?
Jugular vein strain is when a vein on the side of the neck appears to swell (engorgement).
As explained above the person has jugular veins on both sides of the neck. They act as passageways for blood to move from a person’s head to the superior vena cava, which is the largest vein in the upper body.
The superior vena cava then carries blood to the heart and lungs.
Blood flow from the head to the heart is measured by central venous pressure or CVP.
Jugular vein distention or jugular engorgement is when increased pressure from the superior vena cava causes the jugular vein to bulge, making it more visible on the right side of a person’s neck.
The appearance of the vein is similar to a rope or raised tube below the surface of the skin, and its height can be measured to indicate CVP.
An increase in blood volume and a high CVP are signs of heart failure. However, there are other reasons jugular engorgement can occur, such as a blockage.
Causes of jugular engorgement
There are several reasons jugular engorgement can occur, including:
Right heart failure
The right ventricle of the heart is responsible for pumping blood to the lungs to collect oxygen. The left ventricle is responsible for pumping blood to the rest of the body.
People with right-sided heart failure usually have already experienced left-sided heart failure.
The accumulation of blood in the lungs caused by left ventricular failure means that the right ventricle has to work harder and weakens until it can no longer pump effectively. This failure causes the veins to bulge as blood pools.
This condition occurs when the pressure in the blood vessels becomes dangerously high, causing their walls to become thicker and stiffer, which means less blood can pass through. This can damage the right side of the heart and increase pressure in the superior vena cava.
Tricuspid valve stenosis
This is due to a stiffness of the valve that separates the right atrium and the right ventricle from the heart. This results in the blood backing up in the veins.
Obstruction of the superior vena cava
Superior vena cava obstruction can occur if a tumor growing in the chest or a clot in the superior vena cava restricts blood flow in the vein.
If the pericardium or fluid-filled sac around the heart becomes stiff, it can prevent the chambers of the hearts from filling with blood properly. This situation can cause blood to back up in the veins.
This is a condition that occurs when the sac around the heart fills with fluid and no longer allows the heart to fill with blood properly.
This can happen for a variety of reasons, including infection and bleeding. It causes heart failure and jugular engorgement.
Symptoms of jugular engorgement
Symptoms can include:
- Chest pains
- Heart palpitations
- Difficulty breathing.
In addition to the appearance of a bulging jugular vein, other symptoms may appear in a person with jugular engorgement. These additional symptoms can help determine the underlying cause of JVD.
Some symptoms that may appear along with jugular engorgement are considered an emergency and require immediate medical attention.
These symptoms include:
- Excessive sweating
- Blue lips or nails.
- Decreased alertness.
- Fainting or lack of response.
- Chest pain or pressure
- Heart palpitations
- Not being able to produce urine.
- Fast heart rate or tachycardia .
- Rapid weight gain
- Difficulty breathing.
- Wheezing or choking
Other symptoms that can occur along with jugular engorgement are:
- Memory loss.
- Feeling fatigued
- Swelling, especially of the lower extremities.
- Increased need to urinate at night, known as nocturia.
- Decreased appetite.
- Weight changes
- Shortness of breath or rapid breathing, known as tachypnea.
- Soft spot.
Jugular engorgement can be the sign of a serious condition, including heart failure, so it is vital that a medical professional see the person as soon as possible.
While heart failure can happen to anyone, risk factors for heart failure include:
- High blood pressure
- Congenital heart defects.
- Heart attack.
- Use or abuse of alcohol.
- Coronary artery disease
- Some medications
- Sleep apnea.
- Irregular heartbeat
Complications, even with a person’s circulation, can occur along with jugular engorgement and can cause fatigue. They can also cause cognitive or memory difficulties, as well as possible liver and kidney problems.
Diagnosis of jugular engorgement
Woman having throat and neck inspected by doctor.
Diagnosis is usually made simply by inspecting the bulging vein itself.
The appearance of a bulging vein in a person’s neck is enough to diagnose jugular engorgement. However, determining the underlying cause usually requires additional testing.
To find out if there is immediate cause for concern, a doctor can estimate a person’s PVC by measuring the height of the lump.
This measurement will be taken when a person is lying down with their head elevated at a 45 to 60 degree angle.
If the CVP is higher than normal, it may indicate heart failure or that there is high pressure in the lungs that is affecting the right side of the heart.
A doctor will ask about other symptoms, such as chest pain and shortness of breath to help make a diagnosis.
Additional tests may also be performed to determine the underlying cause of jugular engorgement. Listening to the heart can help a doctor detect signs, such as a heart murmur.
A blood test can also reveal problems with the kidney, liver, or thyroid, which can affect the heart and cardiovascular system and cause jugular engorgement.
A doctor may perform other tests, including an EKG, which can reveal any problems with the rate or rhythm of your heartbeat, or an echocardiogram, which can help diagnose heart failure and show signs of valve disease or a heart attack. previous.
Treatment of jugular engorgement
In cases where heart failure is thought to be the underlying cause of jugular engorgement, a doctor will work closely with a person to help improve their health. Treatments include:
- Lifestyle and diet changes.
- Beta-blockers to decrease the activity of the heart and lower blood pressure.
- ACE inhibitors, which help relax blood vessels.
- Diuretics, which help lower blood pressure by removing salt and fluid from the body and relaxing blood vessels.
In the most severe cases, a heart transplant may be necessary.
The most common underlying cause of jugular engorgement is heart failure. A person’s outlook depends on how early this is diagnosed, the extent of the damage, their general health, and how well they respond to treatment.
Early diagnosis is more likely to have a more positive outlook. Anyone experiencing the symptoms of jugular engorgement should see a doctor as soon as possible.