I. History The symptoms described by the patient are not only the main clue to determine the presence of jugular venous anger, but also provide the main reference basis for the etiological diagnosis. Long-term chronic cough with progressive dyspnea is mostly right heart failure caused by pulmonary heart disease; sudden onset, severe chest pain, coughing dark red blood sputum, and dyspnea disproportionate to pulmonary signs suggest pulmonary artery embolism; irregular fever and palpitations are present. In cases of dyspnea and precordial pain, pericardial effusion and constrictive pericarditis should be considered after excluding other infections; in juvenile or adolescent onset, shortness of breath after exertion, weakness, palpitations, and hair groups suggest precordial disease such as primary pulmonary hypertension, pulmonary valve stenosis, Ebstein’s malformation, Eisenmenger’s syndrome, and atrial septal defect. In adolescents, palpitations and dyspnea suggest restrictive cardiomyopathy, but it is less common. Young and middle-aged patients with a history of rheumatic fever, post-activity weakness, palpitations and abdominal distension suggest rheumatic heart valve disease, such as tricuspid stenosis and/or incomplete closure. Physical examination Jugular venous anger with positive jugular venous pulsation is most often seen in severe congestive right heart failure with severe tricuspid valve insufficiency (functional or organic), and systolic pulsation in the veins at the tips of the extremities (e.g., fingers) in response to heart contraction. Superior vena cava obstruction (superior vena cava obstruction syndrome) should be considered in cases of jugular venous anger without hepatic bruising and enlargement and/or lower extremity edema. Experimental examination Pericardial effusion, constrictive pericarditis and pulmonary heart disease mostly have elevated leukocyte count, the first two also often have fast sedimentation, while restrictive cardiomyopathy leukocytosis, especially eosinophilia, is more obvious. Chronic pulmonary heart disease and pulmonary artery embolism, more abnormal blood gas analysis. 4, instrumentation 1, x-ray: chest X-ray or radiography heart shadow to both sides of the expansion, flask-shaped, heart beat weakened or disappeared suggests pericardial effusion; heart shadow is triangular, pericardial calcification, suggesting constrictive pericarditis; caused by right heart failure of various organic heart disease have right atrial enlargement performance, but with chest and lung underlying disease, emphysema and right lower pulmonary artery dilatation, consider pulmonary heart disease. 2. ECG: Atrial hypertrophy, myocardial ischemia, conduction block, ectopic rhythm, etc. can be detected. If there is pulmonary P wave, right ventricular hypertrophy, mostly seen in chronic pulmonary heart disease; SI QIII mostly suggests acute pulmonary artery embolism; low voltage, electric alternating staircase segment is bowed downward elevation mostly suggests pericardial effusion; right ventricular hypertrophy and right bundle branch conduction block, seen in congenital heart disease. 3.Echocardiography: In recent years, echocardiography has a unique status for the diagnosis of certain heart disease etiology and pathology, especially for constrictive pericarditis, pericardial effusion, congenital heart disease, rheumatic heart disease, cardiomyopathy, etc. Specific changes can be found, which is one of the important means for the diagnosis of heart disease etiology. Doppler and color flow imaging techniques can also selectively observe blood flow disorders in a certain part of the heart or large blood vessels, which can be used to diagnose the nature and extent of membrane lesions and the site of congenital cardiovascular malformations. 4, left ventriculography: restrictive cardiomyopathy can be seen endocardial hypertrophy and narrowing of the heart chambers, X-ray selective ventriculography, for the diagnosis of congenital heart disease is valuable. Cardiac radionuclide ventriculography, using the blood pool imaging technique, shows the size of the heart chambers to assist in identifying heart enlargement and pericardial effusion. Radionuclide myocardial visualization helps to identify cardiomyopathy and is valuable in assisting the diagnosis of the nature and location of congenital heart disease shunts, pericardial effusion, and cardiomyopathy.