What Causes JVD?

Jugular vein distention (JVD) occurs when the pressure inside the vena cava, a large vein that carries deoxygenated blood back to the heart, causes a bulging neck vein.

The internal jugular vein and external jugular vein run down both sides of your neck. Bulging of these two jugular veins may be accompanied by pain or discomfort. Additional symptoms depend on the underlying condition causing JVD.

JVD can occur for various reasons and may be a sign of a serious heart problem. It should be evaluated by a medical professional immediately.

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Right-Sided Heart Failure

In the United States, 6.2 million adults have heart failure. Left-sided heart failure is more prevalent, and it can eventually lead to right-sided heart failure.

For people with right-sided heart failure, the left side of the heart has usually already failed, so the right side is under much more pressure to pump blood. Over time, the right side is weakened and cannot work as well.

Blood then accumulates in the veins and leads to a bulging jugular vein. Symptoms can include shortness of breath, edema, and fatigue.

Tension Pneumothorax

A pneumothorax is a collapsed lung, which can happen when air collects between your lungs and chest wall, called the pleural space, and cannot escape. A pneumothorax can be a complete or partial lung collapse.

There are several types of pneumothorax, including open and tension. An open pneumothorax occurs when air accumulates between the chest wall and the lungs as a result of an open chest wound or other physical defect. 

Tension pneumothoraces occur when air accumulates between the chest wall and the lung and increases pressure in the chest, reducing the amount of blood returned to the heart. It can cause jugular vein distention. A tension pneumothorax is a life-threatening condition that needs to be treated as soon as possible.

Pulmonary Hypertension

Pulmonary hypertension is when the pressure of blood in the vessels between the heart and lungs is too high. The pulmonary artery is the blood vessel that carries blood from the heart's right ventricle to the lungs. When pressure increases there, pulmonary hypertension occurs.

Symptoms range from mild to severe. In mild cases, a person may not experience any symptoms, but in more severe cases, pain and loss of consciousness can occur.

Pulmonary hypertension can cause JVD due to the increased pressure in the vein, causing it to bulge. Pulmonary hypertension is a serious medical condition and should be treated by a cardiologist (a heart specialist) or pulmonologist (a lung specialist).

Tricuspid Valve Stenosis

The tricuspid valve is between the right atrium and the right ventricle of the heart. Tricuspid valve stenosis is one of four types of tricuspid valve diseases. In tricuspid valve stenosis, there is a narrowing of the valve opening, restricting blood flow between the upper and lower parts of the right side of the heart.

This condition leads to an enlarged right atrium, resulting in increased pressure and blood flow in the surrounding veins. Tricuspid valve stenosis often causes increased jugular venous pressure and bulging of the vein.

Tricuspid valve stenosis is uncommon and usually occurs along with another valvular issue. If the condition is mild or moderate, treatment may not be needed. However, you should still see a doctor. In severe cases, surgery may be required.

Superior Vena Cava Obstruction

The superior vena cava is one of the main veins in the body. It transports blood from your arms, chest, neck, and head to your heart. The jugular vein is one of several veins of the neck that connect to the superior vena cava. When there is an obstruction in the superior vena cava, it becomes compressed or blocked.

Depending on the severity of the condition, symptoms may be nonexistent or mild. The blockage can progress, causing extreme symptoms, including chest pain, coughing up blood, and wheezing.

This obstruction can cause distention in the axillary veins (paired veins of the upper limb), subclavian veins (paired veins responsible for draining blood from the upper extremities), and jugular veins. Superior vena cava obstruction is rare, but it's serious and often caused by dire conditions like cancer or an infection.

Constrictive Pericarditis

Constrictive pericarditis is a chronic condition in which the pericardium, the membrane around the heart, becomes stiff and inelastic. Due to the loss of elasticity in the pericardium, also called the pericardial sac, cardiac function is negatively impacted, leading to symptoms that gradually worsen.

People with this condition often have a thickened or calcified pericardium, as well as dilation (expansion) of major veins due to the backing up of blood. One of these veins is the jugular vein.

This can result in JVD, which leads to increased venous pressure. Constrictive pericarditis is usually chronic and can be life-threatening if left untreated.

Cardiac Tamponade

Cardiac tamponade is a medical emergency. In this condition, blood and fluid accumulate in the pericardial sac and compress the heart. When this happens, cardiac output is stunted and can also lead to shock, a sudden drop in blood flow throughout the body.

The buildup of fluid that causes cardiac tamponade can be a result of hemorrhage (bleeding) from a penetrating wound to the heart or ventricular wall rupture after a heart attack.

Symptoms usually include chest pain, palpitations, shortness of breath, and altered mental status. A person with cardiac tamponade can also present with JVD due to the backup of blood in the veins.

A Word From Verywell

A jugular vein distention can be uncomfortable and can signal the presence of a serious underlying issue, usually involving the heart and lungs. It's a sign that something is causing the pressure in your veins to rise.

While the causes are serious, they can usually be managed if you seek treatment right away. If you notice that you have a bulging jugular vein along with symptoms like chest pain and shortness of breath, seek medical care as soon as possible.

Frequently Asked Questions

What causes jugular vein distention?

JVD is caused by increased pressure in the jugular veins. As pressure increases, the jugular vein will bulge. This increased pressure can be due to a number of conditions affecting the heart and lungs.

Is heart disease related to jugular vein distention?

Yes, heart disease is the most common cause of JVD, including arrhythmia (irregular heart rhythm), atherosclerosis (a buildup of fat, cholesterol, and other substances in the artery walls), cardiomyopathy (heart muscle disease), congenital heart defects, coronary artery disease, and infections.

Is JVD a sign of dehydration?

No, JVD is not a sign of dehydration. Instead, assessing the jugular vein is part of a physical exam, in which the absence of JVD can be a sign of dehydration.

Why is my neck vein swollen?

The neck is home to three main jugular veins, external, internal, and anterior. These veins drain blood from the neck, face, and head. If a neck vein is swollen, it is a sign that there is increased pressure in that vein. If the jugular vein is bulging, it will be visible on the right side of a person's neck.

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