Journal of the American Society of Echocardiography
State-of-the-Art Review ArticleNoninvasive Evaluation of Right Atrial Pressure
Section snippets
Jugular Venous Pressure (JVP)
Sir Thomas Lewis, in 1930, first proposed the determination of a patient's venous pressure during the physical examination.11 Lewis observed that the top of the jugular veins of normal individuals and the vertical distance from the top of the fluid in the manometer (which was used at that time to measure CVP) always came to lie within 1 to 2 cm of the sternal angle. Currently, examination of JVP is the mainstay of the bedside estimation of CVP.5, 12, 13
Evaluation of CVP using the jugular veins
Conclusions
Currently, there is no single ideal parameter for noninvasive RAP estimation. Using the most recent ASE criteria43 based on IVC parameters, it is most appropriate to categorize RAP into low (0–5 mm Hg), normal (6–10 mm Hg), or elevated (11–20 mm Hg). We believe additional information from some of the methods discussed in this review should aid in the better quantification of RAP. As noninvasive evaluation of RAP involves indirect measurements, multiple factors must be taken into account to
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Dr. Beigel is a recipient of a fellowship grant from American Physicians and Friends for Medicine in Israel (Boston, MA).