JVP Flashcards
What does the “c” wave represent in the JVP trace?
Closure of the tricuspid valve (beginning of ventricular systole)
What does the “X” descent represent in the JVP trace?
Atrial relaxation (during ventricular systole)
What does the “v” wave represent in the JVP trace?
Atrial filling (after ventricular contraction)
What does the “Y” descent represent in the JVP trace?
Blood leaving the right atrium and filling the right ventricle
What is the JVP a measure of?
Right atrial pressure
In pulmonary hypertension and tricuspid or pulmonic stenosis what changes will you likely see in the JVP trace?
1) increased a wave as the right atrium is contracting against more resistance
2) shallow Y descent as right ventricle will not fill as well
In AF what JVP changes are you likely to see?
1) loss of a wave as atria are not contracting properly
2) loss of X descent as atria are not relaxing properly either
What changes to the JVP are likely to occur with complete heart block or VT with AV dissociation?
Intermittent “canon a waves” (REALLY TALL a waves) as every now and again the atria and ventricles are likely to contract at the same time, so the atria will be contracting against a close tricuspid valve (as ventricle stronger)
What JVP changes are you likely to see with tricuspid regurgitation and what is the likeliest cause of tricuspid regurgitation?
“CV” wave: as ventricle contracts retrograde blood flow enters RA increasing the atrial pressure and reducing relaxation which obliterates the X descent. (In severe cases can invert X descent)
Commonest cause of tricuspid regurgitation = Staph aureus endocarditis
How might the JVP trace alter in constrictive pericarditis?
“Square root sign”
As the atria empty into the ventricles they fill normally to begin with and then as the fibrosed ventricle cannot fill any further there is a sharp increase in pressure in the atrium as ventricle tries to eject the blood
How might the JVP trace alter with Cardiac Tamponade?
“Y flattening”
As the blood fills the ventricles from the atria the fluid surrounding the myocardium is pushed up within the pericardium to surround the atria continuing to apply pressure to it hence after as it empties the pressure never disappears
What does the “a” wave represent in the JVP trace?
Atrial contraction
