PTX and JVP

Q: 54 years old male with a previous history of COPD who has been on ventilator for the last few days due to severe ARDS, suddenly developed high peak pressure on the ventilator. CXR confirmed pneumothorax (PTX). In PTX, Jugular Venous Pressure (JVP) tends to be? - select one

A) higher

B) lower

Answer: A

JVP will increase in all situations whenever there is an increase in intrathoracic pressure, such as with positive pressure ventilation, a large pleural effusion, or a pneumothorax. 

Our patient has three reasons to have high intrathoracic pressure. His past history of COPD, presence of a positive pressure ventilator, and PTX.

#physical-exam

#ventilator

#cardiology

Reference:

Jolobe OM. Disproportionate elevation of jugular venous pressure in pleural effusion. Br J Hosp Med (Lond) 2011; 72:582.