With which of the following disorders is jugular vein distention most prominent?
A. Abdominal aortic aneurysm
B. Heart failure
C. MI
D. Pneumothorax
Correct Answer: B. Heart failure
Elevated venous pressure, exhibited as jugular vein distention, indicates a failure of the heart to pump. Increased blood volume, which can occur with heart failure, or anything that interferes with filling of the right atrium or movement of the blood into the right ventricle, can increase the central venous pressure and the amount of jugular vein distention.
Option A: The aorta is the largest blood vessel in the body. It delivers oxygenated blood from the heart to the rest of the body. An aortic aneurysm is a bulging, weakened area in the wall of the aorta. Over time, the blood vessel balloons and is at risk for bursting (rupture) or separating (dissection). This can cause life-threatening bleeding and potentially death.
Option C: An MI, if severe enough, can progress to heart failure, however, in and of itself, an MI doesn’t cause JVD. In patients with acute inferior-wall MI with right ventricular involvement, distention of neck veins is commonly described as a sign of failure of the right ventricle. Impaired right ventricular function also leads to systemic venous hypertension, edema, and hepatomegaly.
Option D: JVD isn’t a symptom of pneumothorax. Tension pneumothorax presents with respiratory distress, jugular venous distention (JVD), diminished breath sounds, tachycardia, and narrow pulse pressure. Although tracheal deviation and jugular venous distention are commonly cited signs of this condition, they both occur late in the condition.
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