This elderly lady was referred to me for a routine evaluation of the neck for some queer feeling of constriction in the throat. On examination both Internal Jugular Veins appeared massively dilated, so a cardac evaluation was suggested. Luckily for her, she agreed and cardiac evaluation showed severe rhythm disturbances requiring immediate pacemaking. Thus a major catastrophe was prevented.
Lessons learnt: Examination of the neck does not mean examining the thyroid, submandibular glands, parotids or lymph nodes only, It also entails examination of the great vessels. Please be careful of transducer pressure, because IJV are collapsible vessels. Also all queer feelings complained by patients should not be dismissed as hysterical.
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