Evaluation of jugular venous pressure in suspected heart failure: does it matter in 2012?

Even in the modern era documentation of raised jugular venous pressure enhances the evaluation of suspected cardiac failure, as shown by a prospective study of 721 adults of mean age 70.7 years in whom an elevated jugular venous pressure contributed 12 points towards the score of >54 needed to generate a >70% probability of heart failure (Kelder et al, 2011). The combination of three items from the clinical history plus six (including jugular venous pressure elevation) from the physical examination showed independent diagnostic value (c-statistic 0.83), which increased to a c-statistic of 0.86 with the addition of natriuretic peptide measurement to the diagnostic armamentarium.