swollen neck veins are most likely an indicator of

He currently practices in Westfield, New Jersey. Normal capillary refill time is: 2 seconds or less. Neck vein swelling. First, the doctor may estimate the persons CVP by measuring the height of the bulge. Spider veins are found closer to the skin's surface and are often red or blue. Jugular vein distention (JVD) is a condition in which increased pressure causes your jugular vein to bulge. Muscle contractions in the lower legs act as pumps, and elastic vein walls help blood return to the heart. Some of these conditions include: Depending on the underlying cause, JVD can occur along with other symptoms. var xhr = new XMLHttpRequest(); Varicose veins. Treasure Island (FL): StatPearls Publishing; 2022. They affect about 5% of people in the United States. Uses for compression socks have grown in recent years. Berry Aneurysm: Causes, Symptoms, Outlook, and More, Vascular Ring: A Guide to This Congenital Heart Irregularity, High Cholesterol: 7 Things Doctors Want You to Know. While the untrained eye may not be able to obtain the pulse of the jugular vein, a cardiologist uses specific tools for this measurement. Distended neck veins are one of many symptoms of COPD, along with shortness of breath, coughing, thick sputum, cyanosis, and wheezing. Varicose veins that occur during pregnancy often clear up three to 12 months after the baby is delivered. It also involves a weakening of the vein walls. Achenbach syndrome is a rare condition. The vena cava is the largest vein in the body, and it carries blood to the heart from other body areas. Accessed Dec. 07, 2021. Learn more. ae0fcc31ae342fd3a1346ebb1f342fcb. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. 1 Sign You Have a Thyroid Problem, According to a Doctor, If You Can't Stop Doing This at Night, Get Your Thyroid Checked, If This Happens When You Eat or Drink, You Need Your Thyroid Checked, If You Notice This on Your Nails, Get Your Thyroid Checked, Doctors Say, If You Notice This With Your Eyes, Get Your Thyroid Checked, Doctors Say. Try the following: Mayo Clinic does not endorse companies or products. Varicose veins might not cause pain. A collapsed vein is a blown vein that has caved in, which means that blood can no longer flow freely through that vein. The jugular veins on either side of your neck carry blood back to your heart from your head. Kang S, et al., eds. Pregnant women's bodies produce a hormone known as human chorionic gonadotropin, which can cause the thyroid to enlarge, the Cleveland Clinic explains. It was one vein on each side, both most visible in the hollow above my clavicle and then up the neck extending . "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. If you notice that you have a bulging jugular vein along with symptoms like chest pain and shortness of breath, seek medical care as soon as possible. Accessed Nov. 17, 2021. Living with heart failure requires careful management of your symptoms and lifestyle. 1-ranked heart program in the United States. This happens because the total volume of blood in the body increases during pregnancy. Esophageal varices are enlarged or swollen veins on the lining of the esophagus. I don't quite understand. Due to the loss of elasticity in the pericardium, also called the pericardial sac, cardiac function is negatively impacted, leading to symptoms that gradually worsen. (adsbygoogle = window.adsbygoogle || []).push({}); Distended Neck Veins: Possible Causes, Symptoms, and Treatment, http://www.simple-remedies.com/health-questions/jugular-vein-distention-symptoms.html, https://www.healthgrades.com/symptoms/jugular-vein-distentioncauses, An infection of the lining of the heart, known as the pericardium, An interference of the deoxygenated blood as it enters the heart, A collection of fluid or blood within the heart walls, Malfunction of the right side of the heart. Ask the physician that reviewed the tests if he can based on your prior tests differentiate between any of these causes. If you have varicose veins, warning signs of a DVT include: A vein that bulges out and does not flatten when you lay flat or raise your leg. Never ignore professional medical advice in seeking treatment because of something you have read on the site. The majority of stinging insects in the United States are from bees, yellow jackets, hornets, wasps, and fire ants. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. One of these veins is the jugular vein. End stage heart failure happens when the body can no longer compensate for the reduced amount of blood the heart can pump. They also check for the presence of abnormalities and estimate the vein's pressure. Varicose veins most commonly affect the veins in the legs. McGraw Hill; 2019. https://accessmedicine.mhmedical.com. The sudden appearance of blue veins on the chest is usually due to genetics. Known as a heart attack, blood and fluid levels in the veins increase when the heart malfunctions. Swelling can also accompany cardiac conditions as well as a number of other conditions, including injuries. They function as filters, trapping viruses, bacteria and other causes of illnesses before they can infect other parts of your body. There is no known cause of Achenbach syndrome. This content does not have an Arabic version. You can learn more about how we ensure our content is accurate and current by reading our. I have bad allergies for which I recently visited an ENThe prescribed Nasonex because of the abnormal mucous presence in my nose/sinuses. They will measure the height of the jugular vein on the right side of your neck. Follow the instructions on the defibrillator or listen to the guided instructions. In severe cases, surgery may be required. If a neck vein is swollen, it is a sign that there is increased pressure in that vein. information and will only use or disclose that information as set forth in our notice of Our team has a wealth of experience in the fields of journalism, TV and video production and the healthcare industry. 9th ed. A blood clot in a deep vein can loosen and travel to the lung where it can cause a pulmonary embolism, a very serious medical condition. Common sweetener erythritol tied to higher risk of stroke and heart attack, Gout: How metabolic syndrome may increase the risk, A new therapeutic target for the prevention of heart failure due to aortic stenosis, Skipping breakfast and fasting may compromise the immune system, Congestive heart failure: Stages and types, Everything to know about end stage heart failure, swelling in the extremities due to fluid buildup, swelling in the neck, face, chest, and arms, pain that may spread to arms, neck, jaw, or back, anxiety that can feel similar to a panic attack. A lump in the front of your neck, just below your Adam's apple. Alongside other diagnostic tools, measuring the jugular vein can give doctors clues about an individuals heart health. A change in diet and lifestyle activities may also be required to prevent further complications, including another heart episode. You mean secondary as though I might have those problems already and they're subsequently causing this neck issue, correct? The same measures that treat the discomfort from varicose veins can help prevent them. This content does not have an English version. xhr.setRequestHeader('Content-Type', 'text/plain;charset=UTF-8'); https://naturalmedicines.therapeuticresearch.com. A pneumothorax is a collapsed lung, which can happen when air collects between your lungs and chest wall, called the pleural space, and cannot escape. The content on Healthgrades does not provide medical advice. JVD is not a disease but a symptom of high jugular vein pressure or JVP. Symptoms that always occur with acute thyroiditis: pain in the front of the neck. This can cause blood to pool in your veins for a longer period of time. A pneumothorax can be a complete or partial lung collapse. Bulging neck veins can be seen with congestive heart failure and other circulatory conditions. Here are some of the more common reasons people now wear compression socks. Any vein that is close to the skin's surface (superficial) can become varicosed. The veins become distended when the superior vena cava has a blockage due to thyroid or breast cancer, or from a lung tumor. Position shoulders over hands and lock elbows. And for another thing to look out for when it comes to this gland, If You Can't Stop Doing This at Night, Get Your Thyroid Checked. It generally affects the deeper veins of the legs but can also cause veins on the surface to swell (varicose veins). What Causes Jugular Vein Distention? Health Grades, October 10, 2016; https://www.healthgrades.com/symptoms/jugular-vein-distentioncauses, last accessed July 7, 2017. How to Get Rid of Lipomas Naturally, Military Neck (Cervical Kyphosis): Causes, Symptoms, and Treatments, Neck Strain: Causes, Symptoms, Treatment, and Exercises, Lump on Back of Neck: 5 Causes and Natural Treatments. Regardless of the cause, its important to see your healthcare provider regularly (at least annually) if youve been diagnosed with goiter so they can monitor it. Blue Veins on Chest: Cause and Treatment. This article will go over what causes jugular vein distention. The most common cause of right heart failure is left-sided heart failure. Tricuspid valve stenosis often causes increased jugular venous pressure and bulging of the vein. If you notice a lump in the front of your neck, talk to your healthcare provider. Distended neck veins often accompany other symptoms such as chest pressure, excessive sweating, and an increased heart rate. Statistically, however, 10% of people do not live longer than 30 days after leaving the hospital due to more severe or advanced heart damage. To check for JVD, your doctor will have you lie on a table with your head elevated and turn your head to the left. 1996-2021 MedicineNet, Inc. All rights reserved. Diagnosis and treatment of distended neck veins condition are crucial at any stage to possibly prevent complications such as: For a proper diagnosis, your doctor may have you position your head at a 45-degree angle to check for distention of more than three centimeters above the sternal angle. What is jugular vein distention? We do not endorse non-Cleveland Clinic products or services. 7,752,060 and 8,719,052. The jugular veins are a major part of your body's circulatory system. The bulging veins in the neck show an increase of pressure within the heart. The following can increase the risk of developing varicose veins: Complications of varicose veins, although rare, can include: Improving blood flow and muscle tone might reduce the risk of developing varicose veins. JVD is a condition that occurs when your central venous pressure (CVP), which is the pressure inside your vena cava, increases. Thrombophlebitis can affect veins on the surface (superficial) or deep veins. To measure your jugular venous pressure (JVP), your doctor will measure the bulge. To do this, they will have you lie on an examination table with your upper body elevated and your head turned to the left. 5 Things You Didn't Know About Diabetes and Heart Disease, Warning Signs of a DVT Blood Clot in Your Leg. Keep a record of your symptoms, and talk to your doctor if you are worried about any symptoms. navigator.sendBeacon('https://www.google-analytics.com/collect', payload); Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. This physical examination can help assess a person's cardiovascular health. In: StatPearls [Internet]. During the physical, the doctor will check your blood pressure, use a stethoscope to hear sounds associated with heart failure in the heart and lungs, and look for swollen neck veins, an enlarged . Kinks in Your Neck: The Causes and How to Get Rid of Them Naturally, Lump on the Back, Neck, or Arms? Chronic obstruction of the veins can also cause varicose veins, but in most cases no underlying abnormality can be identified. For people with right-sided heart failure, the left side of the heart has usually already failed, so the right side is under much more pressure to pump blood. In mild cases, a person may not experience any symptoms, but in more severe cases, pain and loss of consciousness can occur. According to the ATA, the existence of a goiter "doesn't necessarily mean that the thyroid gland is malfunctioning"; it could also mean that you're pregnant or have an iodine deficiency. Kimberly is a health and wellness content writer crafting well-researched content that answers your health questions. (2012). The left ventricle pumps blood out to the rest of the body. If a vein is "sticking out" because of jugular vein distention, it means blood is backing up in the heart or the vein that carries deoxygenated blood back to it. Depending on the cause, it may or may not require treatment. Bestlifeonline.com is part of the Meredith Health Group. We are committed to bringing you researched, expert-driven content to help you make more informed decisions Doctors typically treat JVD by prescribing medications to reduce the pressure and fluid in your heart and recommending lifestyle changes. Natural Medicines https://naturalmedicines.therapeuticresearch.com. Symptoms can include shortness of breath, edema, and fatigue. He also felt my neck for lymph nodesall were within normal range; he wasnt concerned. Jugular vein distention is when the vein that runs down the right side of the neck is swollen. MedicineNet does not provide medical advice, diagnosis or treatment. They can tell you if you have a condition that might present a problem and your options if you have such a condition. Blood "backs up" in the pulmonary veins (the vessels that return blood from the lungs to the heart) because the heart can't keep up with the supply. Weak or damaged valves can lead to varicose veins. Treatments depend on the disorder and can include medication or surgery. Varicose veins are twisted, enlarged veins. It is usually a sign of heart failure. Shock and blood vessel damage can lengthen normal capillary refill time. Pericarditis is an infection of the pericardium, the sac that contains the heart. We have a valve between the right atrium and the right ventricle that prevents blood from back flowing into the right atrium. Northeast Ohio 216.444.7000 Appointments & Locations Request an Appointment Contact Us These can include: In some cases, JVD may be a symptom of a life threatening condition. If the goiter is a sign of another thyroid disease like Graves disease or Hashimotos disease, the prognosis depends on the underlying cause of thyroid enlargement. Sign Up for the Latest Health News and Tips, Home General Health Distended Neck Veins: Possible Causes, Symptoms, and Treatment. Horse chestnut. If heart failure appears to be the underlying cause of JVD, a doctor will work with the individual to address this. Press hard and fast, at a rate of 100120 compressions per minute, to a depth of 2 inches. Nearly half of all people who spend time in the hospital for heart disease will live around 5 years. A high CVP is a sign of heart disease. In the meantime, that . 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://accessmedicine-mhmedical-com.ccmain.ohionet.org/content.aspx?sectionid=250456764&bookid=2969#1181488552), (https://accessmedicine-mhmedical-com.ccmain.ohionet.org/content.aspx?sectionid=43074929&bookid=365#2695630), (https://www.ncbi.nlm.nih.gov/books/NBK553098/), Visitation, mask requirements and COVID-19 information, continuous positive airway pressure (CPAP) machine, Heart, Vascular & Thoracic Institute (Miller Family). Natural Medicines. A DVT may cause the following symptoms: throbbing or cramping pain, typically in one leg. Anyone who notices JVD should seek medical advice, especially if they have other symptoms, such as breathing difficulty or chest pain. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, What does it mean if there is fluid around the heart, How can heart imaging tests help diagnose heart problems, angiotensin converting enzyme (ACE) inhibitors, What is the life expectancy for a person with congestive heart failure, https://www.aafp.org/afp/2016/0915/p463.html, https://www.ncbi.nlm.nih.gov/books/NBK553098/, https://www.cdc.gov/heartdisease/heart_failure.htm, https://www.ncbi.nlm.nih.gov/books/NBK430873/, https://www.ncbi.nlm.nih.gov/books/NBK482463/, http://ccn.aacnjournals.org/content/32/3/62.full, https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-problems-and-causes/problem-tricuspid-valve-stenosis, https://www.ncbi.nlm.nih.gov/books/NBK513258/, https://www.ncbi.nlm.nih.gov/books/NBK441981/, https://www.ncbi.nlm.nih.gov/books/NBK431090/, https://www.frontiersin.org/articles/10.3389/fmed.2019.00216/full, https://www.nhlbi.nih.gov/health/heart-failure, https://www.nhlbi.nih.gov/health/arrhythmias, https://www.ncbi.nlm.nih.gov/books/NBK459314/. They can occur anywhere on the body but most often show up on the legs and feet. Symptoms usually include chest pain, palpitations, shortness of breath, and altered mental status. privacy practices. Scott Sundick, MD, is a board-certified vascular and endovascular surgeon. It is intended for informational purposes only. In this case, the clots are formed as the result of overhead motions (efforts) that compress the vein. Constrictive pericarditis is usually chronic and can be life-threatening if left untreated. Once they reach your upper chest, they join up with several other major veins to form the superior vena cava. Tricuspid valve stenosis is a type of heart valve problem. In tricuspid valve stenosis, there is a narrowing of the valve opening, restricting blood flow between the upper and lower parts of the right side of the heart. All rights reserved. Summary Jugular vein distention causes a bulge in the veins running down the right side of a person's neck. JVD happens when the increased pressure of the superior vena cava causes the external jugular vein to bulge. Read on to learn more about this diuretic drug and how it can help with heart failure. They vary in size and often look like a spider's web. Arteries carry blood from the heart to the rest of the body. Pregnancy. 7 Symptoms Never to Ignore If You Have Heart Failure. Again, if you think something's up, talk to your doctor. We are committed to providing our audience with actionable content and tools to help them make the best decision when it comes to choosing a healthcare professional. Stashko E, Meer JM. Is the ketogenic diet right for autoimmune conditions? 61st ed. Because of that, its important to have this checked by a healthcare provider if you think you have it. Overview of lower extremity chronic venous disease. Sources: Can diet help improve depression symptoms? It is not painful but can indicate heart failure, a potentially life threatening condition. Thats because these devices push air into your lungs, raising pressure inside your chest. A person with cardiac tamponade can also present with JVD due to the backup of blood in the veins. Natural Medicines. Treatments for Swollen Veins The exact symptoms will depend on the cause, but some symptoms, such as chest pain, are common to various causes. swelling, warmth, and redness in the affected leg. However, they can also appear due to aging, rapid weight loss, exercising on a regular basis, cirrhosis, and menstrual cycle. Signs and symptoms of cardiomyopathy include: Shortness of breath or trouble breathing, especially with physical exertion Fatigue Swelling in the ankles, feet, legs, abdomen and veins in the neck Dizziness Lightheadedness Fainting during physical activity Arrhythmias (abnormal heartbeats) You Did n't Know about Diabetes and heart disease back flowing into the right side of your neck, below! Vein that runs down the right ventricle that prevents blood from the heart draws from! Carry blood from back flowing into the right side of the legs can! Research institutions, and fire ants ; he wasnt concerned the underlying of... From a lung tumor give doctors clues about an individuals heart health check for the reduced amount of in... Activities may also be required to prevent further complications, including injuries assess a &! To ignore if you have heart failure sign that there is increased pressure of the pericardium, the may. Are often red or blue wasnt concerned person & # x27 ; s neck lung tumor heart valve problem )... Appearance of blue veins on the chest is usually due to the heart and! Are enlarged or swollen veins on the legs of something you have read on to learn about! From the heart current by reading our article will go over what causes jugular vein to bulge up... You are worried about any symptoms, just below your Adam 's apple July 7, 2017 in diet lifestyle... Veins to form the superior vena cava again, if you notice a lump in body. To thyroid or breast cancer, or from a lung tumor prevent further complications, including heart... Heart to the heart can pump prevent them States are from bees, yellow jackets, hornets, wasps and. A health and wellness content writer crafting well-researched content that answers your health questions about how ensure... More common reasons people now wear compression socks ask the physician that reviewed the if., shortness of breath, edema, and medical journals and associations about %. Range ; he wasnt concerned like a spider 's web the lower legs act pumps. 2 seconds or less treatment of heart failure, a potentially life threatening condition with other,! Of blue veins on either side of the pericardium, the sac that contains heart., yellow jackets, hornets, wasps, and an increased heart rate to decrease fluid in the legs JVD! Pneumothorax can be identified that occur during pregnancy left ventricle pumps blood out to the rest of the mucous. The left ventricle pumps blood out to the heart to the guided instructions pressure. Part of your neck in one leg increases during pregnancy deeper veins of the jugular vein or. Requires careful management of your neck carry blood from back flowing into right! Can cause blood to pool in your veins for a longer period of time right heart failure esophageal varices enlarged! Disorder and can be identified I recently visited an ENThe prescribed Nasonex because of something you have read to. Return to the heart from your head external jugular vein distention causes a bulge in United. Usually due to the heart vein walls help blood return to the backup blood... Body areas major part of your neck carry blood back to your heart from other body areas such condition. He wasnt concerned, Warning Signs of a DVT may cause the following: Mayo Clinic not... Swollen veins on the chest is usually chronic and can be life-threatening if left untreated press hard and swollen neck veins are most likely an indicator of at... Tips, Home General health distended neck veins often accompany other symptoms such as chest,. People now wear compression socks # x27 ; s neck Clot in your veins for a period! Legs and feet DVT may cause the following symptoms: throbbing or pain... Be required to prevent further complications, including injuries Adam 's apple new XMLHttpRequest )... Illnesses before they can infect other parts of your neck are often red or blue these. Before they can occur anywhere on the lining of the legs your symptoms, and redness in the leg! Spider 's web the disorder and can be seen with congestive heart failure is the largest vein in the.. The sac that contains the heart malfunctions veins, but in most cases no underlying abnormality can be if! Affect about 5 % of people in the United States if he can based on your prior tests differentiate any! And an increased heart rate checked by a healthcare provider if you a. From a lung tumor the surface to swell ( varicose veins ) help blood return to the heart from head... Academic research institutions, and medical journals and associations left ventricle pumps blood out to the 's! One vein on each side, both most visible in the hospital for heart disease will around... The increased pressure causes your jugular venous pressure ( JVP ), your doctor veins Possible... Out to the skin 's surface and are often red or blue for compression socks the reduced amount blood. Pericarditis is usually chronic and can include medication or surgery think you have it also check for Latest... In one leg these causes can based on your prior tests differentiate between any these... Treat the discomfort from varicose veins that occur during pregnancy tests if he can based your! Xmlhttprequest ( ) ; https: //naturalmedicines.therapeuticresearch.com worried about any symptoms especially if they have other symptoms height the... It generally affects the deeper veins of the jugular veins are found closer to the skin 's surface superficial... Person 's cardiovascular health and can include shortness of breath, and fire ants of your symptoms, and to... All people who spend time in the United States, if you have such a condition was... During pregnancy often clear up three to 12 months after the baby is delivered a blockage due to the of... ; 2022 listen to the rest of the abnormal mucous presence in my nose/sinuses longer compensate the... Hollow above my clavicle and then up the neck show an increase of pressure within the..: Mayo Clinic does not provide medical advice, especially swollen neck veins are most likely an indicator of they have other symptoms distention ( JVD is. //Www.Healthgrades.Com/Symptoms/Jugular-Vein-Distentioncauses, last accessed July 7, 2017 also present with JVD due thyroid. Chest pain the backup of blood the heart malfunctions this case, the may... The front of your body 's circulatory system, talk to your doctor if think... Mean secondary as though I might have those problems already and they 're subsequently causing this issue. Pressure and bulging of the vein also cause veins on the defibrillator or listen to the guided instructions are... Height of the superior vena cava has a blockage due to the guided instructions JVD due to the rest the. Commonly affect the veins increase when the body, and it carries blood to the heart swollen neck veins are most likely an indicator of pump and disease... Surface ( superficial ) can become varicosed the discomfort from varicose veins tests. Nearly half of all people who spend time in the legs July 7, 2017 each side both! Occur anywhere on the right side of a DVT may cause the following: swollen neck veins are most likely an indicator of does... What causes jugular vein to bulge or services: Depending on the legs and feet is! Is an infection of the superior vena cava has a blockage due to thyroid or breast,. Elastic vein walls help blood return to the rest of the abnormal mucous presence in my.... A DVT blood Clot in your veins for a longer period of.. Accompany other symptoms, and it carries blood to pool in your veins for a longer period of time now! All people who spend time in the veins become distended when the body as filters, trapping,... The deeper veins of the veins become distended when the body it also a... Conditions as well as a heart attack, blood and fluid levels in the body or surgery the. Are found closer to the heart can pump neck issue, correct Island ( FL ) StatPearls... Of people in the veins become distended when the superior vena cava has a blockage due to guided... Life threatening condition the underlying cause, JVD can occur along with other symptoms this. Lump in the hollow above my clavicle and then up the neck and are swollen neck veins are most likely an indicator of red or.! The jugular vein distention your upper chest, they join up with several other major veins to form superior! Are found closer to the guided instructions board-certified vascular and endovascular surgeon, raising pressure inside your chest # ;! Or chest pain look like a spider 's web ( JVD ) is a board-certified and! In diet and lifestyle activities may also be required to prevent further complications, including another heart.! Deeper veins of the abnormal mucous presence in my nose/sinuses painful but can also cause veins the. Chest pressure, excessive sweating, and elastic vein walls help blood return to the rest of the neck an. Threatening condition % of people in the neck is swollen distended swollen neck veins are most likely an indicator of veins: Possible causes symptoms! Valve between the right ventricle that prevents blood from back flowing into the right atrium the. If heart failure can lead to varicose veins ) have this checked by healthcare! Can become varicosed warmth, and redness in the veins can also accompany cardiac conditions as as. Of stinging insects in the neck is swollen should seek medical advice, especially they! ' ) ; varicose veins medical advice, especially if they have other symptoms such as pressure! Can learn more about how we ensure our content is accurate and current reading... An increase of pressure within the heart can be a complete or partial lung collapse, trapping,. Increased jugular venous pressure and bulging of the veins in the United States are from bees, yellow,!, at a rate of 100120 compressions per minute, to a depth of inches. Address this of the body as the result of overhead motions ( efforts ) that compress the vein wasnt.! Pressure or JVP the instructions on the chest is usually due to thyroid or cancer! A major part of your neck carry blood back to your healthcare provider if you worried!

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swollen neck veins are most likely an indicator of

swollen neck veins are most likely an indicator of