The Rational Clinical Examination
David L. Simel, Drummond Rennie
Abnormal Central Venous Pressure
David L. Simel, Deborah Cook
central venous pressure, measurement of, central venous pressure-biological function, fourth heart sound, myocardial infarction, vein of neck
"A 48-year-old man who has had 2 myocardial infarctions is having
trouble sleeping. He claims shortness of breath while supine but
does not notice any ankle edema. The lungs are clear, whereas the
cardiac evaluation reveals an S4 but no S3 heart
sound. There is a short systolic murmur along the left sternal border.
He has no peripheral edema. You look at his large, thick neck and
have no confidence that you will be able to assess the neck veins...."
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