Elevation in central venous pressure most likely indicates which?

• A. Left ventricular failure
• B. Hypovolemia
• C. Pulmonary embolism
• D. Right ventricular failure or fluid overload

Answer: (D)

Central venous pressure reflects the pressure in the right atrium and back up into the venous system. When CVP is elevated, it means the right heart is facing higher filling pressures or there is an excess of fluid in the systemic venous circulation. The classic situation producing this pattern is right-sided heart problems or fluid overload, such as right ventricular failure or volume excess, which backs up into the veins.

Left ventricular failure mainly causes pulmonary congestion and symptoms related to the lungs rather than a prominent rise in right-sided pressures. Hypovolemia lowers CVP because there is less volume returning to the heart. A pulmonary embolism can put strain on the right ventricle and may raise CVP, but the strongest, most consistent fit among the options is right ventricular failure or fluid overload, explaining the elevated CVP.