Dr. Mariano M. Alimurung Memorial lecturer, Dr. Eugenio Reyes, delivered a timely and thought-provoking talk on the art and evolution of Jugular Venous Pressure (JVP) assessment.
It all started with the idea of coming out with a JVP tool that is handy, user-friendly, accurate and affordable.
Seeing his young colleagues grappling with the JVP detection, a bedside physical finding using two rulers and a small flashlight, Dr. Eugenio Reyes, then UP-PGH Training Officer and UP-PGH Cardiology Department head, strengthened his resolve to invent a JVP diagnostic tool. This was during the tailend of the pandemic in 2022.
Known for his heart for the poor, he and his colleagues at the UP-PGH, were keen on pursuing this project.
Reyes said that “the advent of technology paved the way for the introduction of diagnostic options that are very expensive, and the lack of skills on the proper use of this crucial tool eventually relegated JVP to the background.”
With the UP SIBOL (Surgical Innovation Biotechnic Laboratory), as sponsor, he and his group have been working on the JVP prototype electronic eJVP device to this day. Target date of completion and launching in 2026, he said.
A valuable tool in cardiology, it offers critical insights into right atrial pressure and overall cardiovascular functions.
In his discussion, Reyes presented his prototype which he had personally patented. “Currently, we are in the process of meticulously fine-tuning the prototype leading to its mass production,” he said.
Once the all-new JVP tool is produced, Reyes said, this particular diagnostic tool would be a lot cheaper, fetching not more than P1000. He added that the results can normally be seen by the naked eye through the JVP. The test is definitely budget-friendly -- and faster -- compared to various laboratory diagnostic tests.
Reyes said that with JVP, the assessment is done by visually observing the pulsations of the internal jugular vein in the neck. An elevated JVP suggests increased right atrial pressure, which can be indicative of conditions like heart failure, tricuspid regurgitation, pulmonary hypertension, or constrictive pericarditis. Conversely, a low JVP can suggest hypovolemia or dehydration.
Reaffirming its value as a cornerstone of bedside diagnosis, Reyes’ new prototype—the electronic JVP (eJVP) device – is designed to address the long-standing challenges of accuracy, consistency, and clinical reliability. Furthermore, he said, his prototype device integrates the principles of the Pythagorean theorem to facilitate quantitative measurement.
Careful observation of the JVP waveform, including its distinct a, c, and v waves, can provide further clues about underlying cardiac pathology. Accurate interpretation requires proper patient positioning and differentiation from the carotid pulse.
Reyes also demonstrated the proper technique for measuring JVP, stressing the importance of patient positioning to ensure reliable results.
“For those who do not know how to use the JVP, I must say, you should not focus on Heart Failure. So, when you go home, you must start to learn it, because practice makes perfect,” he said.
To further challenge the young cardiologists among the attendees, Reyes quoted renowned Ohio State University cardiologist Carl Leier:
“The inability to properly assess the pressure level and wave contour of the internal jugular veins should encourage the Cardiologist interested in heart failure to either learn and develop the skills in this component of the physical examinations or move to another area of cardiovascular medicine.”
While underscoring the importance of continuous innovation in medical diagnostics and the potential of combining traditional clinical skills with modern technology to improve patient care, Reyes believes that an accurate JVP assessment remains a cornerstone of the cardiovascular physical exam, guiding clinicians towards appropriate diagnostic testing and treatment strategies.
The PHA past president is known for his outstanding brand of leadership and service in research, education, clinical practice, and in the formulation of health policies.
Earlier, at the opening ceremony of the 55th Convention and Scientific Meeting of the PHA-PCC, Reyes was conferred the Loyalty Award together with Dr. Ma. Rosan A. Trani.
Dr. Eugenio Reyes
Fr. L: Drs. Orlando Bugarin, Aurora Gamponia, Eugenio Reyes, Rodney Jimenez, Walid Amil and Luigi Pierre Segundo
