An elevated CVP is primarily indicative of dysfunction in which heart chamber?

An elevated central venous pressure (CVP) primarily reflects dysfunction of the right atrium. CVP is a measurement of the pressure in the thoracic vena cava, which reflects the volume of blood returning to the heart and the ability of the heart to pump it into the arterial system.

When the right atrium has difficulty accepting blood, whether due to increased resistance from conditions such as right-sided heart failure, tricuspid valve disease, or fluid overload, the pressure within the system increases. This leads to elevated CVP readings. Furthermore, since the right atrium plays a crucial role in receiving deoxygenated blood from the systemic circulation, its dysfunction directly results in increased back pressure, making CVP a key indicator of its performance and the overall hemodynamic status of the patient.

Conditions affecting other heart chambers, such as the left atrium, right ventricle, or left ventricle, do not directly correlate with changes in CVP, which is why they are not the primary causes of elevated CVP. Understanding this concept is essential in critically assessing patients, particularly in the intensive care setting.