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, 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 essential body parts, such as the brain, face, and neck.
Anatomically, two of these veins are 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.
The left vein is generally smaller and thinner than the right, but both contain valves that help transport blood. The vein appears dilated (more expansive) at two points, and these different parts are called the upper bulb and lower bulb.
The vein is essential in evaluating jugular 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 more significant than most others, it is commonly used as an entry point for placing venous lines and tubes (catheters) 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, the most prominent vein in the upper body.
The superior vena cava then carries blood to the heart and lungs.
Central venous pressure or CVP measures blood flow from the head to the heart.
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 skin’s surface, and its height can be measured to indicate CVP.
Increased blood volume and a high CVP are signs of heart failure. However, there are other reasons for jugular engorgement, such as blockage.
Causes of jugular engorgement
There are several reasons jugular engorgement can occur, including:
Right heart failure
The heart’s right ventricle 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 the 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 grows 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 seats from filling with blood correctly. This situation can cause blood to back up in the veins.
This condition occurs when the sac around the heart fills with fluid and no longer allows the heart to fill with blood appropriately.
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 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 is known as tachypnea.
- Soft spot.
Jugular engorgement can signify a severe condition, including heart failure, so a medical professional must 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 cause fatigue. They can also cause cognitive or memory difficulties and possible liver and kidney problems.
Diagnosis of jugular engorgement
Woman having throat and neck inspected by a 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 an 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 usual, it may indicate heart failure or increased pressure in the lungs that affects the heart’s right side.
A doctor will ask about other symptoms, such as chest pain and shortness of breath, to help diagnose.
Additional tests may also be performed to determine the underlying cause of jugular engorgement. Listening to the heart can help a doctor detect signs like a heart murmur.
A blood test can also reveal kidney, liver, or thyroid problems, affecting the heart and cardiovascular system and causing 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 decrease the activity of the heart and lower blood pressure.
- ACE inhibitors help relax blood vessels.
- Diuretics 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 damage’s extent, general health, and how well they respond to treatment.