Atrial Cycle and JVP

Question 1

Summary of JVP/Atrial cycle

Answer 1

Question 2

What causes the JVP?

Answer 2

Transmission of right atrium pressure back up through the JV

Question 3

What can cause a raised JVP?

Answer 3

1. Complete Heart dissociation
2. AF
3. Tricuspid valve regurgitation
4. SVC obstruction
5. Increased fluid level eg hypernaetrimia

Question 4

List the 5 stages

Answer 4

1. A wave
2. C wave
3. X descent
4. V wave
5. Y descent

Question 5

What part represents atrial systole and diastole?

Answer 5

A wave

Question 6

Which parts represent ventricular systole and diastole?

Answer 6

C wave

X descent

V wave

Y descent

Question 7

What happens at the A wave?

Answer 7

Atrial contraction and blood comes back up the internal jugular

Increase in atrial pressure

Question 8

What happens at the C wave?

Answer 8

Pressure rises again to closing of atrioventricular (Tricuspid valve)

Question 9

What happens at the x descent?

Answer 9

Pressure falls as atrium relaxes and it begins to suck blood back in from the vena cava

Question 10

What happens at the V wave?

Answer 10

Pressure begins to rise again as blood enters the atrium

Question 11

What happens at the Y descent?

Answer 11

Falling pressure as atrial valve opens and blood flows passively into ventricle

Atrium then contracts and A wave begins

Question 12

What does a lost A wave mean?

Answer 12

Atrial Fibrillation (No p on qrs so no ventricular contraction)

Question 13

What does a large A wave mean?

Answer 13

Tricuspid stenosis

Question 14

What does a cannon A wave suggest?

Answer 14

Contracting against a closed tricuspid valve, eg complete dissociation

Question 15

What does a steep y descent suggest?

Answer 15

Atrial constriction as it doesn’t flow to ventricle smoothly in diastole, eg constrictive pericarditis