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a good cardiovascular examination requires more than observation you must think about the possible meanings of your individual observations fit them together in a logical pattern and correlate your cardiac findings with the patients blood pressure arterial pulses jugular venous pulsations the rest of your head-to-toe examination and the patients history with the patient supine begin the cardiac examination one of the most important and frequently used skills of physical examination and often the first step in your cardiovascular assessment is estimating the jugular venous pressure or jvp in the beginning this will seem difficult but with time you will find that the jvp provides valuable information about the patients volume status and cardiac function the usual starting point for assessing the jvp is to ensure that the head of the examination table or bed is elevated to 30 degrees be sure to distinguish the undulating jugular waveform from carotid artery pulsations the steps for me