What does a collapsing internal jugular vein (IJV) that then refills signify?

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Last updated: April 7, 2025View editorial policy

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From the Research

A collapsing jugular vein that then refills is a normal physiological finding during a clinical examination of the jugular venous pressure (JVP), indicating proper venous function and normal right heart hemodynamics. This observation is supported by a study published in 2012 1, which found that the collapse of the jugular vein during deep inspiration suggests a normal JVP. When a person is positioned at a 45-degree angle, the jugular vein should partially collapse during inspiration as negative intrathoracic pressure draws blood into the chest, and then refill during expiration as pressure normalizes. This normal fluctuation reflects healthy cardiac function, particularly of the right side of the heart.

Key Points to Consider

  • Abnormalities in this pattern, such as distended veins that don't collapse with inspiration or abnormal waveforms, may suggest conditions like right heart failure, tricuspid valve disease, or pericardial effusion.
  • The jugular venous examination is an important bedside assessment tool that provides information about a patient's volume status and right heart function without requiring invasive procedures.
  • When performing this examination, proper patient positioning and adequate lighting are essential for accurate assessment.
  • A more recent study published in 2022 2 highlights the role of internal jugular venous ultrasound in assessing central venous pressure and clinical outcomes in patients with suspected or confirmed heart failure, but the fundamental principle of jugular vein collapse and refill remains a key indicator of normal JVP.
  • Another study from 2022 3 explores the use of optical hemodynamic imaging to assess jugular venous compliance, further emphasizing the importance of understanding jugular venous dynamics in the context of cardiac function.
  • Additionally, a study from 2020 4 discusses the response of jugular venous pressure to exercise in patients with heart failure, indicating that changes in JVP can be prognostically useful, but this does not alter the basic interpretation of a collapsing and refilling jugular vein as a sign of normal physiology.

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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