Which of the following is a sign of heart failure?

• A. Low venous pressure
• B. Normal JVP
• C. Elevated JVP
• D. No edema

Answer: (C)

Venous congestion from heart failure raises central venous pressure, which shows up as an elevated jugular venous pressure. When the heart can’t move blood forward effectively, blood backs up in the venous system, and the neck veins become distended. Clinically, this is assessed by observing the jugular venous pulsation with the patient at a 30–45-degree incline; elevated JVP is a clear sign of backward failure and systemic venous congestion.

In contrast, low venous pressure or a normal JVP suggests there isn’t the backward venous congestion seen in heart failure, and while edema is a common accompanying feature, its absence doesn’t rule out heart failure. The key point is that elevated JVP directly reflects the congestive aspect of the condition.