Although clinicians began to associate conspicuous neck veins with heart disease almost 3 centuries ago1,2, the practice of
actually measuring a patient’s venous pressure during physical examination is only several decades old. Even Sir James
Mackenzie, who in the late 1800s described most of what we now know about bedside diagnosis of the jugular venous pulse – the a, c, and v waves, venous sounds, cannon a waves, venous waveforms in heart disease, and bedside diagnosis of atrial fibrillation (by examination only of the pulse and neck veins, before the era of electrocardiography) 3,4 – totally ignored the concept of measuring venous pressure.