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A person with congestive heart failure who presented with an exceedingly elevated JVP, the arrow is pointing to the external jugular vein(marked by the arrow) however, JVD is measured by the internal jugular vein which can also be seen here.
James Heilman, MD. http://commons.wikimedia.org/wiki/File:Elevated_JVP.JPG. Accessed July 2013.
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