Jugular vein distention (JVD) causes a bulge in the veins running down the right side of a person’s neck. It results from increased pressure in a large vein called the vena cava. JVD can signify heart failure and other cardiovascular problems.

Doctors refer to the pressure in the vena cava as jugular venous pressure (JVP). It is not painful but can indicate heart failure, a potentially life threatening condition.

Alongside other diagnostic tools, measuring the jugular vein can give doctors clues about someone’s heart health.

This article discusses the causes of JVD and treatment options.

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People have three types of jugular veins: the exterior, interior, and anterior jugular veins. Both sides of the neck have one of each type.

The jugular veins allow blood to move from the head to the superior vena cava, the largest vein in the upper body. The superior vena cava then transports the blood to the heart and lungs.

Doctors measure blood flow from the head to the heart by assessing central venous pressure (CVP). CVP can also help assess how well the heart is working and estimate the balance of fluids in the body.

JVD occurs when the increased pressure of the superior vena cava causes the external jugular vein to bulge. When this happens, it becomes 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. To assess JVD and CVP, a doctor will measure the height of the vein.

An increased volume of blood and high CVP are signs of heart failure. However, JVD can occur for other reasons, such as a blockage.

Four potential reasons for high JVP and JVD are:

  • heart failure, when the heart no longer pumps blood as well as it should
  • fluid overload, which leads to edema and swelling in the abdomen and lower limbs
  • constrictive pericarditis, which affects the sac that surrounds the heart
  • cardiac tamponade, when fluid other than blood takes up space in the heart

Here are some reasons why these can occur:

Right sided heart failure

The right ventricle of the heart is responsible for pumping blood to the lungs to collect oxygen. The left ventricle pumps blood out to the rest of the body.

The most common cause of right heart failure is left sided heart failure. The blood accumulation in the lungs caused by left ventricle failure means the right ventricle has to work harder and becomes weaker until it cannot pump blood effectively anymore.

Right ventricular heart failure causes the veins to bulge as blood accumulates.

Pulmonary hypertension

This condition occurs when the pressure in blood vessels is too high for a long time. It causes the blood vessel walls to thicken and stiffen, meaning less blood can pass through.

Pulmonary hypertension can damage the right side of the heart and increase pressure in the superior vena cava, leading to heart failure.

Tricuspid valve stenosis

Tricuspid valve stenosis is a type of heart valve problem. It results from a narrowing of the opening of the tricuspid valve. This valve separates the right atrium and the right ventricle of the heart. This narrowing restricts blood flow, and blood can back up in the veins.

Common causes are infective endocarditis and rheumatic fever. These conditions are not common in the United States.

Superior vena cava obstruction

Superior vena cava (SVC) obstruction can occur if a blockage occurs in the chest, preventing blood from flowing through the SVC.

This could be due to a tumor growing in the chest or a clot in SVC. It is part of SVC syndrome and can lead to coughing, breathing difficulty, facial swelling, and lightheadedness.

Constrictive pericarditis

Pericarditis is an infection of the pericardium, the sac that contains the heart. In time, damage can cause the sac to lose elasticity. This can prevent the chambers of the heart from filling up with blood properly and can cause the blood to back up in the veins.

Cardiac tamponade

This occurs when the sac around the heart fills up with fluid, no longer allowing the heart to fill with blood properly. It can happen for several reasons, including infection and bleeding. It causes heart failure as well as JVD.

JVD refers to a bulging jugular vein, but it may occur alongside other symptoms of the underlying cause. The exact symptoms will depend on the cause, but some, such as chest pain, are common to various conditions:

Chest pain and shortness of breath can indicate severe illness, such as a heart attack, and need immediate medical attention.

JVD can signal a severe condition, including heart failure. Heart failure can affect anyone, but a person may have a higher risk if they are over the age of 65 years or have:

As well as JVD, a person may have:

  • shortness of breath
  • difficulty breathing when lying down
  • swelling in the lower limbs or abdomen due to fluid retention
  • fatigue

If someone goes to the doctor with a bulging vein in their neck, the doctor will likely:

  • ask about their symptoms
  • ask about their personal and family medical history
  • carry out a physical examination, including listening to their heart
  • order tests to find an underlying reason

First, the doctor may estimate the person’s CVP by measuring the height of the bulge. If the CVP is unusually high, it may indicate heart failure or another condition putting pressure on the heart.

Other tests may include:

  • blood tests to rule out problems with the kidneys, liver, or thyroid, which can affect the cardiovascular system
  • an electrocardiogram to assess heart rhythms
  • echocardiogram to look for signs of damage to the heart

If heart failure appears to be the underlying cause of JVD, a doctor will work with the person to address this. Treatment will aim to:

  • improve a person’s quality of life
  • manage their symptoms
  • reduce their risk of complications

Options can include:

In some cases, a heart transplant may be necessary.

JVD may occur due to heart failure. A person’s outlook depends on how early they receive a diagnosis, the extent of the damage, their overall health, and how well they respond to treatment.

Early diagnosis is more likely to lead to a more positive outlook. Anyone experiencing the symptoms of JVD should contact a doctor as soon as possible.

Nearly half of all people who spend time in the hospital for heart disease will live around 5 years. Statistically, however, 10% of people do not live longer than 30 days after leaving the hospital due to more severe or advanced heart damage.

JVD is not a disease but a symptom of high jugular vein pressure or JVP. It is usually a sign of heart failure. The risk of heart failure is higher in people with high blood pressure and other conditions related to heart disease.

Someone with JVD will notice an enlarged vein running down the right side of the neck. A doctor may measure the height of this vein to estimate central venous pressure (CVP). A high CVP is a sign of heart disease.

Jugular vein distention (JVD) is swelling of the vein that runs down the right side of the neck. This happens when blood is unable to flow as it should. The blood backs up in the vein, increasing jugular vein pressure, or JVP.

JVD is usually a sign of heart failure, which often involves high blood pressure. Anyone who notices JVD should seek medical advice, especially if they have other symptoms, such as breathing difficulty or chest pain.