What question did this study set out to answer?

To determine the sensitivity, specificity, and clinical utility of the bedside cardiovascular physical examination in predicting cardiac hemodynamics in patients with advanced chronic congestive heart failure.

September 13, 2026Journal of the American College of CardiologyOpen Access

Bedside cardiovascular examination in patients with severe chronic heart failure: Importance of rest or inducible jugular venous distension

Q: What is the clinical evidence from this study?

Study design: Observational. Population: advanced chronic congestive heart failure (n=52). Intervention: Jugular venous distension (at rest or inducible) vs. Absence of jugular venous distension. Primary outcome: Elevation of the pulmonary capillary wedge pressure (≥ 18 mm Hg).

Q: What does this research mean for the field?

In patients with severe chronic heart failure, resting or inducible jugular venous distension predicts elevated pulmonary capillary wedge pressure (≥18 mm Hg) with 81% sensitivity and 80% specificity. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Resting or inducible JVD predicts elevated PCWP with ~81% accuracy.

n=52

Why the study?

The reliability of bedside cardiovascular physical signs in estimating hemodynamics in patients with chronic heart failure had recently been questioned.

Population

52 patients with chronic congestive heart failure undergoing evaluation for possible heart transplantation

Design

Prospective observational study

Authors

SBSamuel M. ButmanScottsdale Community College GEGordon A. EwyGeneral Cardiology JSJames R. StandenRoyal North Shore Hospital

Discussion

Member takes

Implication

Prospective study demonstrates high diagnostic accuracy of jugular venous distension for elevated heart pressures in chronic heart failure, highlighting the utility of bedside exams.

Key Points

To determine the sensitivity, specificity, and clinical utility of the bedside cardiovascular physical examination in predicting cardiac hemodynamics in patients with advanced chronic congestive heart failure.
Prospectively evaluated 52 patients with chronic congestive heart failure undergoing inpatient evaluation for heart transplantation.
Recorded bedside physical signs (including pulmonary rales, third heart sound, resting jugular venous distension, and the abdominojugular test) and compared them with hemodynamics measured via right heart catheterization, chest radiography, and multigated nuclear scans.
Pulmonary rales, a left ventricular third heart sound, jugular venous distension, and a positive abdominojugular test were each associated with higher right heart pressures and reduced cardiac performance.
Jugular venous distension at rest or induced by the abdominojugular test demonstrated 81% sensitivity, 80% specificity, and 81% predictive accuracy for elevated pulmonary capillary wedge pressure (≥18 mm Hg), with an 0.86 probability of elevation when either sign was present.

Study Design

Type

Observational (n=52)

PICO

Population

52 patients with chronic congestive heart failure undergoing in-hospital evaluation for possible heart transplantation.

Exposure / Comparator

Jugular venous distension (at rest or inducible) vs Absence of jugular venous distension

Primary Outcome

Elevation of the pulmonary capillary wedge pressure (≥ 18 mm Hg)

Cite This Study

Butman et al. (1993) conducted an observational in advanced chronic congestive heart failure (n=52). Jugular venous distension (at rest or inducible) vs. Absence of jugular venous distension was evaluated on Elevation of the pulmonary capillary wedge pressure (≥ 18 mm Hg). The presence of jugular venous distension, at rest or inducible, predicted an elevated pulmonary capillary wedge pressure (≥18 mm Hg) with 81% sensitivity, 80% specificity, and 81% predictive accuracy.

synapsesocial.com/papers/6aa66a76805167d96e050295 https://doi.org/10.1016/0735-1097(93)90405-p

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September 13, 2026Journal of the American College of CardiologyOpen Access

Bedside cardiovascular examination in patients with severe chronic heart failure: Importance of rest or inducible jugular venous distension

View Full Paper

Ask AI

Bookmark

Key result

Resting or inducible JVD predicts elevated PCWP with ~81% accuracy.

n=52

Why the study?

The reliability of bedside cardiovascular physical signs in estimating hemodynamics in patients with chronic heart failure had recently been questioned.

Population

52 patients with chronic congestive heart failure undergoing evaluation for possible heart transplantation

Design

Prospective observational study

Authors

SBSamuel M. ButmanScottsdale Community College GEGordon A. EwyGeneral Cardiology JSJames R. StandenRoyal North Shore Hospital

Discussion

Member takes

Implication

Prospective study demonstrates high diagnostic accuracy of jugular venous distension for elevated heart pressures in chronic heart failure, highlighting the utility of bedside exams.

Key Points

To determine the sensitivity, specificity, and clinical utility of the bedside cardiovascular physical examination in predicting cardiac hemodynamics in patients with advanced chronic congestive heart failure.
Prospectively evaluated 52 patients with chronic congestive heart failure undergoing inpatient evaluation for heart transplantation.
Recorded bedside physical signs (including pulmonary rales, third heart sound, resting jugular venous distension, and the abdominojugular test) and compared them with hemodynamics measured via right heart catheterization, chest radiography, and multigated nuclear scans.
Pulmonary rales, a left ventricular third heart sound, jugular venous distension, and a positive abdominojugular test were each associated with higher right heart pressures and reduced cardiac performance.
Jugular venous distension at rest or induced by the abdominojugular test demonstrated 81% sensitivity, 80% specificity, and 81% predictive accuracy for elevated pulmonary capillary wedge pressure (≥18 mm Hg), with an 0.86 probability of elevation when either sign was present.

Study Design

Type

Observational (n=52)

PICO

Population

52 patients with chronic congestive heart failure undergoing in-hospital evaluation for possible heart transplantation.

Exposure / Comparator

Jugular venous distension (at rest or inducible) vs Absence of jugular venous distension

Primary Outcome

Elevation of the pulmonary capillary wedge pressure (≥ 18 mm Hg)

Cite This Study

synapsesocial.com/papers/6aa66a76805167d96e050295 https://doi.org/10.1016/0735-1097(93)90405-p

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