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Symptoms » Abdominal swelling » Book Sections
 

Jugular Venous Distension

Examination of the jugular venous pulse for abnormalities of the wave form or level of venous pressure is a critical component of the cardiovascular exam and can aid in the diagnosis of certain cardiac diseases.

Differential Diagnosis

  • Congestive heart failure
  • Constrictive pericarditis
  • Cardiac tamponade
  • Superior vena cava syndrome
  • Tricuspid regurgitation
  • Heart block (most often complete heart block)
  • Atrial fibrillation
  • Right ventricular infarction
  • Tricuspid stenosis
  • Right ventricular dilation
  • Hypervolemia

Workup and Diagnosis

  • History and physical examination
    –Best to evaluate the right internal jugular vein
    –Best seen in tangential light from foot of bed
    –Venous pulsation can be obliterated with compression, but arterial pulsation cannot
    –Right atrium lies 5 cm below the sternal angle (reference point)
    –Normal central venous pressure ≤8–9 cm
    –Hepatojugular reflex is a helpful adjunct in patients with normal central venous pressure suspected of having right heart failure
  • ECG may reveal atrial fibrillation, ventricular tachycardia, right ventricular infarction, heart block, or other pathology
  • Chest X-ray may reveal signs of congestive heart failure or cardiomegaly
  • Echocardiogram is helpful to evaluate for valvular disease, myxomas, and right ventricular dysfunction
  • Additional diagnostic testing depends on the suspected pathology

Treatment

  • Treatment depends on the underlying disease process
  • Atrial fibrillation
  • Ventricular tachycardia: DC countershock in presence of hemodynamic instability; antiarrhythmic therapy with amiodarone or lidocaine; repletion of electrolytes with torsade de pointes; ICD to treat recurrences
  • Constrictive pericarditis: Judicious management of volume status; pericardial stripping hemodynamic compromise is substantial
  • Tricuspid regurgitation/stenosis: Surgical correction if symptomatic or severe enough
  • Atrial myxoma: Surgical excision
  • Heart block may require permanent pacemaker

Book Source Details

  • Book Title: In a Page: Signs and Symptoms
  • Author(s): Scott Kahan, Ellen G. Smith
  • Year of Publication: 2004
  • Copyright Details: In a Page: Signs and Symptoms, Copyright © 2004 Lippincott Williams & Wilkins.

Other Book Chapters Related to Abdominal swelling

Read excerpts from these other book chapters related to Abdominal swelling:

Medical Books Excerpts
  • ASCITES
  • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
  • Ascites
  • "In A Page: Pediatric Signs and Symptoms" (2007)
  • Edema
  • "In A Page: Pediatric Signs and Symptoms" (2007)
  • Dyspepsia
  • "Handbook of Signs & Symptoms (Third Edition)" (2006)
  • Ascites
  • "A Pocket Manual of Differential Diagnosis" (1999)
  • Edema
  • "A Pocket Manual of Differential Diagnosis" (1999)
  • Dyspepsia
  • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
  • Abdominal Pain
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • Ascites
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • Edema
  • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
  • Edema
  • "Field Guide to Bedside Diagnosis" (2007)
  • Abdominal pain
  • "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
  • Edema, facial
  • "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
  • Edema, generalized
  • "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
  • Dyspepsia
  • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
  • Abdominal Pain
  • "The Diagnostic Approach to Symptoms and Signs in Pediatrics" (2006)
  • Edema
  • "The Diagnostic Approach to Symptoms and Signs in Pediatrics" (2006)
  • Dyspepsia
  • "Nursing: Interpreting Signs and Symptoms" (2007)
 

Copyright Details: In a Page: Signs and Symptoms, Copyright © 2008 Williams & Wilkins.

More About Causes of Abdominal swelling




More About This Book:
Title: In a Page: Signs and Symptoms
Authors: Scott Kahan, Ellen G. Smith
Publisher: Lippincott Williams & Wilkins
Copyright: 2004
ISBN: 1-4051-0368-X

 » Next page: Abdominal Pain (In A Page: Pediatric Signs and Symptoms)

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