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Previous Volume 353:2408-2409 December 1, 2005 Number 22 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: In the article by Pinto et al. (Sept. 1 issue),¹ the examination of the sailor presenting with dyspnea and weight gain revealed that his "jugular venous pressure was not elevated," leading the discussant to dismiss a cardiac cause. In fact, the jugular venous pressure should have been elevated in this patient, who had a pericardial effusion severe enough to cause peripheral edema, ascites, pleural effusions, and hepatic congestion with transaminitis and coagulopathy.

When reclining patients are examined, a markedly elevated jugular venous pressure can be misinterpreted as "not elevated" because of obstruction by the ear or jaw. . . . [Full Text of this Article]

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