Regular Carotid Pulsation and Discernible Internal Jugular Venous Pulse

A woman in her 50s was admitted to the hospital after several months of progressive dyspnea on exertion and severe lower extremity edema. She had undergone aortic valve replacement for aortic stenosis, 2-vessel coronary artery bypass, and permanent pacemaker placement 1 year before presentation. A neck examination at 60° (depicted in this video) shows the location of the carotid and internal jugular pulsations. What is your diagnosis?

[rxmcgree]

This is a challenging case. Diagnosis here is restrictive cardiomyopathy which has likely been caused by radiotherapy she received for Hodgkin lymphoma. The first thing to do is to observe closely and distinguish the double pulsation of the JVP from the carotid pulse, both of which are visible. Once you have done this try to see how the JVP waves are related in timing with the carotid pulse. In the JVP you can see an A wave, V wave and rapid Y descent. Kussmaul sign can be seen on inspiration at 0.30. If you follow the link in the description it gives background to the case and a full explanation and results from left and right heart catheterisation. Given that the JVP us essentially a reflection of right atrial pressure the measured pressures give the best explanation of what is going on in the heart. Please note this is a teaching case aimed at clinicians. Visible pulsations in the neck are very complex and most doctors would struggle to make a diagnosis on seeing these alone. The diagnosis here was only reached after intensive investigation. If you are not medically trained I would not try to draw any conclusions from this video about your own health! Some people will be able to see the carotid pulse in their neck without any underlying illness but if you are worried I recommend seeking medical advice.

[cowgirleva]

Idk if this might help someone… I just had my pulsing neck checked out and it was caused by an inflamed thyroid. Mine didn’t have anything to do with heart issues. I was freaked because I thought I was having a heart attack when in reality I have a hyper active thyroid that was swelling my neck causing the arteries to become visible 🙏.

[samgaming]

Many thanks for this video resource. I would like to also inform people about the hepatojugular reflex. This is seen in LV failure with pulmonary hypertension, and involves pressure over the liver for 10 seconds, whereupon there is an increase in JVP followed by an abrupt fall. It can also be used when you cannot see the JVP very well, as it will bring the JVP up.

[lebronkofi]

Is there any medicine for this please. My mum is suffering.

[gnarkill]

Ive had this for a long time, finally got EKG and Holter monitor.

[kanwalbibi]

Can someone tell me what exactly this is and if it’s dangerous. My neck is pulsating like this for almost 9 months now. My doctor told me it’s normal but I don’t know many people with same issue. It’s more visible while laying down however I can still see it when I sitting.

[mosadik]

I’m getting it now since 2 weeks on my right side of the neck. Very distracting and annoying. Like 7 times a day or more

[carlymoore]

oh I found the link to the diagnosis. strangely I was diagnosed with pericardits in 2016...so maybe I should book an appointment. I took a few vidoes of it as mine does not do it constantly, just random times.

[SizweSithebe-gbzj]

mine has been twitching on my left side it's been 4 days now what does it mean¿

[Wil_Dsense]

Anyone also get pain in the right side of neck, associated with feeling prominent heart beating in the right area of neck? It used to be loud whooshing (pulsatile) but now it is just painful radiating same rhythm as heart. Also get migraines and sometimes feel it dull aching and pressure back of the head/across shoulders.

[carlymoore]

I could not see the diagnosis in the comments. Does anyone know?

[kerryarmstrong]

What causes your neck to do this? My neck has been doing this for about a day and a half now and it’s driving me nuts. Blood pressure and pulse seem to be fine. The vein in my neck is just bulging like crazy

[jamukhan]

Sometime such in the same place of neck veins make sound,
Don't know the name of disease.
What problem can happend?
Could anyone tell?

[opisthorchisviverrini]

Are both 'a' and 'v' waves elevated?

[breanettiagrayson]

My neck and heart beat at the same time but throb very hard almost like my heart is about to pop out of my chest

[Zweiihandre]

Is this normal? i have this sometimes and Im a bit fat and starting to loose weight. Is it normal? Its usually more prominent in my right, and its not as powerful as this video, its more light wave motion, and I can only feel it with my hands.
Can it be cause by sinus arythmia ? Cause I did a heart beat thing and the result say I have sinus arythmia but Im scared .
Is it caused by stress? Cause the past few weeks I have been stress cause of school work

Maybe its me over exerting myself from my exercise?

[jubaidaluna]

I got that problem from before yesterday. Can anyone tell me about that whoever knows please

[carlymoore]

I have had a fast twitch in that area for two days. after googling..i feel worried.

[larrymendez]

My husband carotid pulse I like that specially when he is lying down in supine position with his face facing the left side..is it ok? I’m kinda worried

[rupabhuju]

I have same prblm.. is it serious prblm??😕😕