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

Doctors call the pressure in the vena cava 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 an individual’s heart health.

In this article, we look at the causes of JVD and treatment options.

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A person has three types of jugular veins. They are the exterior, interior, and anterior jugular veins. There is one of each on both sides of the neck.

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 happens 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 assess 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.

The four main 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

What does it mean if there is fluid around 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 (RV) 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

This 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 results in restricted blood flow and blood can back up in the veins. Common causes are infective endocarditis and rheumatic fever. These are not common in the United States. Tricuspid valve stenosis is a type of heart valve problem.

Superior vena cava obstruction

Superior vena cava (SVC) obstruction can occur if a blockage occurs in the chest and prevents 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. This situation 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. This can happen for a variety of reasons, including infection and bleeding. It causes heart failure, as well as JVD.

Jugular vein distention refers to a bulging jugular vein, but it may happen alongside other symptoms. These are the symptoms of underlying conditions that can cause JVD.

The exact symptoms will depend on the cause, but some symptoms, such as chest pain, are common to various causes.

Heart failure:

Pulmonary hypertension:

  • shortness of breath
  • chest pain
  • fatigue
  • swelling in the extremities due to fluid buildup

Tricuspid valve stenosis:

Constrictive pericarditis:

Cardiac tamponade:

SVC obstruction:

  • swelling in the neck, face, chest, and arms
  • distended veins
  • a cough
  • shortness of breath
  • redness in the eyes

Chest pain and shortness of breath are signs of severe illness and need immediate medical attention.

Is it a heart attack?

Heart attacks occur when there is a lack of blood supply to the heart. Symptoms include:

  • chest pain, pressure, or tightness
  • pain that may spread to arms, neck, jaw, or back
  • nausea and vomiting
  • sweaty or clammy skin
  • heartburn or indigestion
  • shortness of breath
  • coughing or wheezing
  • lightheadedness or dizziness
  • anxiety that can feel similar to a panic attack

If someone has these symptoms:

  1. Dial 911 or the number of the nearest emergency department.
  2. Stay with them until the emergency services arrive.

If a person stops breathing before emergency services arrive, perform manual chest compressions:

  1. Lock fingers together and place the base of hands in the center of the chest.
  2. Position shoulders over hands and lock elbows.
  3. Press hard and fast, at a rate of 100–120 compressions per minute, to a depth of 2 inches.
  4. Continue these movements until the person starts to breathe or move.
  5. If needed, swap over with someone else without pausing compressions.

Use an automatic external defibrillator (AED) available in many public places:

  1. An AED provides a shock that may restart the heart.
  2. Follow the instructions on the defibrillator or listen to the guided instructions.
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JVD can signal a severe condition, including heart failure.

Heart failure can affect anyone, but a person may have a higher risk if they 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

What are the stages of heart failure?

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

  • ask them about their symptoms
  • ask them about their personal and family medical history
  • carry out a physical examination, including listening to their heart
  • carry out some 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

How can heart imaging tests help diagnose heart problems?

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

Treatment will aim to:

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

Options include:

In some cases, a heart transplant may be necessary.

What are some natural diuretics?

The most common underlying cause of JVD is 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 see 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.

What is the life expectancy for a person with congestive heart failure?

Here are some questions people often ask about jugular vein distention.

What is the most common cause of jugular vein distention?

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.

How do I know if I have jugular vein distention?

You will notice that the vein that runs down the right side of your neck has become enlarged. 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 is when the vein that runs down the right side of the neck is swollen. 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.