All concepts, explanations, trials, and studies have been
re-written in plain English and may contain errors. I am
not a doctor
-----------------------------------------------------------

INTRODUCTION
The independent prognostic value of elevated jugular venous
pressure or a third heart sound in patients with heart failure
is not well established.

METHODS
We analyzed SOLVD trial data, in which 2,569 CHF patients
were randomly assigned to take either enalapril or placebo.
The average follow-up was 32 months. High jugular vein
pressure or a third heart sound was found by physical exam
on entry into the trial.
	The risks for worsening heart failure, hospitalization,
and death from pump failure were compared in patients with
these findings and in patients without these findings.

RESULTS
Elevated jugular vein pressure was linked to increased risk
of hospitalization for heart failure, death or
hospitalization for heart failure, and death from pump
failure. The presence of a third heart sound was linked to
similar higher risks for these outcomes.

CONCLUSIONS
In CHF patients, elevated jugular vein pressure and a third
heart sound are each independently linked with bad outcomes,
including progression of heart failure. Looking for these
findings with physical exam is clinically meaningful.

Source:  N Engl J Med. 2001;345(8):574-581 8/23, 2001 Number 8
Title:   Prognostic Importance of Elevated Jugular Venous
         Pressure and a Third Heart Sound in Patients with Heart
         Failure
Authors: Mark Drazner, J. Rame, M. Phil, Lynne Stevenson,
         Daniel Dries
E-mail:  mark.drazner@utsouthwestern.edu