Page 80 - Clinical Pearls in Cardiology

68 Clinical Pearls in Cardiology

• The examiner should shine a torch light tangentially
from behind the neck of the patient so as to throw a
jugular shadow (Fig. 3).
• While examining for the right jugular pulsations, the
examiner should lean over to the left side of the
patient who is reclining in the 45 degree propped up
position, to obtain a clear silhouette of the skin
overlying the right internal jugular vein.
• Inspiration may make jugular venous pulsations
more prominent.
• Elevation of lower limbs will increase the venous
return to right atrium and make the venous pulsations
more prominent.

Fig. 3: Shining torch light tangentially from behind the patient