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Open Access 03-01-2017 | Heart Beat

Enlarged jugular veins

Auteurs: M. Boulaksil, R. M. M. Gevers

Gepubliceerd in: Netherlands Heart Journal | Uitgave 4/2017

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Extras
Video of serial contrast injections showing flebograms of two anterior jugular veins (venae jugulares anteriores) running parallel which are connected caudally by a jugular arch (arcus venosus juguli). See also Fig. 1.
Opmerkingen

Electronic supplementary material

The online version of this article (doi: 10.​1007/​s12471-016-0940-5) contains supplementary material, which is available to authorized users.
An 83-year-old woman presented to our emergency department with a two-week history of progressive dyspnoea on exertion and leg oedema, and no syncope. She had a history of hypertension, diabetes mellitus type 2, renal insufficiency, and left bundle branch block.
She was clinically mildly decompensated. The ECG showed sinus rhythm with total AV block and a ventricular escape rhythm of 30/min. Echocardiography showed normal left and right ventricular systolic function and a dilated inferior vena cava with decreased variation.
During pacemaker implantation, a remarkable anatomy of the jugular veins was noticed. An aberrant trajectory of the wire was perceived from the left subclavian vein to the contralateral side (Fig. 1a and online video). After contrast injection, two large veins were observed running parallel to one another which were connected caudally (Fig. 1b). Furthermore, the left brachiocephalic vein and superior vena cava (Fig. 1b and 1c) are appreciated.
We concluded that the anatomy consisted of enlarged anterior jugular veins (venae jugulares anteriores) and a jugular arch (arcus venosus juguli) [1]. This is a common anatomy, but these jugular veins are rarely enlarged [2]. Probably, this has to do with the increased venous pressure due to backward heart failure.

Acknowledgements

We thank Dr. Marc Vorstenbosch, Associate Professor at the Department of Anatomy of the Radboud University Medical Center, Nijmegen, the Netherlands, for his critical appraisal of this manuscript.

Conflict of interest

M. Boulaksil and R.M.M. Gevers declare that they have no competing interests.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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Netherlands Heart Journal

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Caption Electronic Supplementary Material

Video of serial contrast injections showing flebograms of two anterior jugular veins (venae jugulares anteriores) running parallel which are connected caudally by a jugular arch (arcus venosus juguli). See also Fig. 1.
Literatuur
1.
go back to reference Schummer W, Schummer C, Bredle D, Frober R. The anterior jugular venous system: variability and clinical impact. Anesth Analg. 2004;99:1625–9.CrossRefPubMed Schummer W, Schummer C, Bredle D, Frober R. The anterior jugular venous system: variability and clinical impact. Anesth Analg. 2004;99:1625–9.CrossRefPubMed
2.
Metagegevens
Titel
Enlarged jugular veins
Auteurs
M. Boulaksil
R. M. M. Gevers
Publicatiedatum
03-01-2017
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 4/2017
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-016-0940-5