Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Feb 26, 2024; 16(2): 73-79
Published online Feb 26, 2024. doi: 10.4330/wjc.v16.i2.73
Seeing beneath the surface: Harnessing point-of-care ultrasound for internal jugular vein evaluation
Vichayut Chayapinun, Abhilash Koratala, Taweevat Assavapokee
Vichayut Chayapinun, Taweevat Assavapokee, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
Abhilash Koratala, Division of Nephrology, Medical College of Wisconsin, Wauwatosa, WI 53226, United States
Author contributions: Chayapinun V drafted the initial version of the manuscript; Assavapokee T and Koratala A have designed the manuscript; Assavapokee T and Koratala A have revised the manuscript for critical intellectual content.
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Abhilash Koratala, MD, Associate Professor, Division of Nephrology, Medical College of Wisconsin, 8701 W Watertown Plank Road, HUB 7th Floor, Wauwatosa, WI 53226, United States.
Received: December 20, 2023
Peer-review started: December 20, 2023
First decision: January 11, 2024
Revised: January 16, 2024
Accepted: February 1, 2024
Article in press: February 1, 2024
Published online: February 26, 2024

Point-of-care ultrasound (POCUS) of the internal jugular vein (IJV) offers a non-invasive means of estimating right atrial pressure (RAP), especially in cases where the inferior vena cava is inaccessible or unreliable due to conditions such as liver disease or abdominal surgery. While many clinicians are familiar with visually assessing jugular venous pressure through the internal jugular vein, this method lacks sensitivity. The utilization of POCUS significantly enhances the visualization of the vein, leading to a more accurate identification. It has been demonstrated that combining IJV POCUS with physical examination enhances the specificity of RAP estimation. This review aims to provide a comprehensive summary of the various sonographic techniques available for estimating RAP from the internal jugular vein, drawing upon existing data.

Keywords: Point-of-care ultrasound, Bedside ultrasound, Internal jugular vein, Right atrial pressure, Central venous pressure

Core Tip: Point of care ultrasound of the internal jugular vein serves as a non-invasive tool to evaluate right atrial pressure. This is particularly useful when neck vein inspection is challenging, or inferior vena cava sonography lacks reliability. When combined with the physical examination and other sonographic parameters, it becomes a valuable component of bedside hemodynamic evaluation.