Feasibility of Remote Video Assessment of Jugular Venous Pressure and Implications for Telehealth

Abstract

Guideline-directed management of heart failure includes assessment of volume status, 1 for which estimation of jugular venous pressure (JVP) is the most reliable bedside marker. [2][3][4] Whether JVP can be assessed remotely, as would occur during a telemedicine visit, is unknown. Given the dramatic increase in telemedicine visits during the coronavirus disease 2019 (COVID-19) pandemic, this question has gained further importance. We conducted a prospective observational study comparing JVP estimates performed at bedside and over video chat with invasively measured right atrial pressure (RAP).

Delivering Personalized Care at a Distance: How Telemedicine Can Foster Getting to Know the Patient as a Person

“…If serious, acute illness is suspected, in-person emergency medical care would be recommended. However, patients, with or without a caregiver, may be able to engage in a range of maneuvers that can facilitate neurologic, musculoskeletal, dermatologic, and other examination components, even jugular venous pressure assessment [ 19 , 50 , 53 ]. Remote monitoring technologies, which tend to be underutilized, can be leveraged to provide additional clinical data and empower patients as active participants in self-monitoring, and telemedicine visits provide an opportunity for any teaching that may be needed to ensure patients are using these devices correctly.…”

Optimizing the Potential for Telehealth in Cardiovascular Care (in the Era of COVID-19): Time Will Tell

“…A 31-patient study found both bedside and remote jugular venous pressure (JVP) estimates were significantly and comparably correlated with invasively measured right atrial pressures. 35 Encouraging patients to participate in their physical examination, particularly in the more tangible maneuvers such as obtaining their vital signs or abdominal palpation, could also foster more engaging delivery of care. Biosensing wearables and other validated diagnostic tools are needed to bridge the limitations in the physical examination.…”

Risk assessment in patients with pulmonary arterial hypertension in the era of COVID 19 pandemic and the telehealth revolution: State of the art review

“…Yet, health care providers learn much from observing the general appearance and behavior of the patient and may still capture certain findings such as the skin exam, including the appearance of wounds, catheter sites, device implant incisions, extremity swelling, or rashes, as well as breathing patterns and physical movement. A recent study compared the remote assessment of jugular venous pulsation (JVP), an arguably essential part of the physical examination of a PAH or HF patient, to the bedside assessment of JVP in patients with systolic left heart failure 30 . The study showed that bedside and remote JVP estimates were comparable (R 2 and potential adverse effects, particularly in patients who are on continuous intravenous prostacyclin therapy.…”