Is JVP (Jugular Venous Pressure) measured from the external or internal jugular vein?

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Last updated: February 9, 2025View editorial policy

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From the Guidelines

JVP can be measured from either the internal or external jugular vein.

Measurement Considerations

  • The choice between internal and external jugular vein depends on practicality and patient positioning, with the internal jugular vein being the more common choice for evaluation 1.
  • When the internal jugular veins are impractical for evaluation, the external jugular veins can be used as an alternative 1.

Clinical Assessment

  • The measurement of JVP involves positioning the patient between supine to sitting to visualize the top of the venous pulsation 1.
  • The distance in centimeters for jugular pulsations above or below the sternal angle is used to estimate jugular venous pressure, with adjustments made based on patient position 1.
  • Clinical assessment of JVP is an important part of evaluating right ventricular filling in decompensated heart failure 1.

From the Research

Measurement of Jugular Venous Pressure (JVP)

  • JVP can be measured from both the external and internal jugular veins, as evidenced by various studies 2, 3, 4, 5, 6.
  • The internal jugular vein is often used for measuring JVP, as it is directly connected to the right atrium of the heart via the superior vena cava 2.
  • However, the external jugular vein can also provide a reliable estimate of central venous pressure, and is easier to visualize than the internal jugular vein 3, 4.
  • Ultrasonography can be used to measure JVP, and has been shown to be a reliable and easy-to-perform method 5, 6.
  • The normal range for JVP measured using ultrasonography has been determined to be around 6.35 cm 5.

Comparison of Internal and External Jugular Veins

  • Studies have compared the measurement of JVP using the internal and external jugular veins, and have found that the external jugular vein can provide a reliable estimate of central venous pressure 3, 4.
  • The internal jugular vein is more directly connected to the heart, but the external jugular vein is easier to visualize and can provide a reliable estimate of JVP 3, 4.
  • The choice of vein for measuring JVP may depend on the individual patient and the clinical situation, as well as the availability of ultrasonography equipment 2, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Method for measuring jugular venous pulse with a miniature gyroscope sensor patch.

Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference, 2023

Research

Estimation of central venous pressure by ultrasound of the internal jugular vein.

The American journal of emergency medicine, 2000

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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