JUGULAR VENOUS PULSE

Characteristic wave patterns of JVP:

• a wave  –  right atrial contraction
• x descent –  atrial relaxation
• c wave  –  bulging of tricuspid valve into the right atrium during RV isovolumetric contraction
• v wave  –  increase in volume in venecava during systole, when tricuspid valve is closed
• y descent  –  tricuspid valve opening and rapid inflow of blood into the right ventricle

Abnormalities on JVP

Giant ‘a’ wave

• Tricuspid stenosis
• Right atrial myxoma
• Pulmonary hypertension

Cannon ‘a’ waves

• Junctional rhythm
• AV dissociation
• Complete heart block

Absent ‘a’ wave

• Atrial fibrillation

Reversal of ‘x’ descent

• Tricuspid regurgitation

Accentuated `a-x’ descent

• Constrictive pericarditis
• Cardiac tamponade
• Restrictive cardiomyopathy

Accentuated `v-y’ descent

• Tricuspid regurgitation
• Constrictive pericarditis

Reduced v-y descent

• Tricuspid stenosis
• Right atrial myxoma

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