A 55-year-old man shows signs of superior vena cava syndrome. What additional finding is likely to be seen on examination?

In cases of superior vena cava syndrome, one of the hallmark findings during a physical examination is increased jugular venous pressure (JVP). This condition typically occurs due to obstruction of blood flow through the superior vena cava, which can be caused by malignancies, thrombosis, or other compressive processes.

When the superior vena cava is obstructed, blood cannot efficiently return to the heart from the head, neck, and upper extremities, leading to a backup of venous pressure. This manifests as distended neck veins and a high JVP on examination. The increased pressure can also be observed in the veins of the upper body, contributing to symptoms such as facial swelling, engorged neck veins, and other signs of venous congestion.

The other options provided do not directly correlate with the findings typical of superior vena cava syndrome. The S4 heart sound is indicative of decreased ventricular compliance and is not specifically associated with this condition. A pansystolic murmur generally suggests a valvular issue, such as mitral regurgitation, which does not arise from superior vena cava obstruction. Bisferiens carotid pulsation is often seen in conditions like aortic regurgitation or hypertrophic cardiomyopathy, rather than in the context