Jugular Venous Pulse via Left Internal Jugular Vein
The right internal jugular vein is the preferred site to evaluate the jugular venous pulse. Sometimes it is unavailable because of thrombosis or the presence of a catheter. In other patients, it is simply not well seen on the right for unknown reasons. In such circumstances, the left internal jugular vein may be used to evaluate the jugular venous pulse. The left internal jugular vein has been shown to be nearly as accurate as the right internal jugular vein for evaluation of central venous pressure.
Patient 1:
This patient was in the hospital with new systolic heart failure following an ST-elevation myocardial infarction (STEMI). The jugular venous pulse is sometimes better visualized on the left than the right, as in this case. The astute observer will also note the presence of Kussmaul’s sign in this case.
Jugular Venous Pulse Via Left IJ
Patient 2:
This is a young woman with nonischemic dilated cardiomyopathy related to methamphetamine use, who was admitted to the hospital with decompensated heart failure. The jugular venous pulse was easily visualized via the left internal jugular vein.
Jugular Venous Pulse Via Left IJ