JVP Flashcards
What does the JVP demonstrate?
Pressure within the right atrium
- No valves b/een RA & IJV - ‘column of blood’ between the two acts as a manometer
How do you measure the JVP?
Patient lies at 45 degrees
Find IJV
Measure vertical height from the sternal angle
What is a normal JVP?
Below 4cm
What is an additional test to perform when measuring JVP?
Abdomino-jugular reflux test
What is a normal result from the Abdomino-jugular reflux test?
IJV pulse should stay normal or rise for 1-2 beats, then fall
What is a POSITIVE abdomen-jugular reflux test?
IJV rises at least 4cm or more and is sustained throughout the 30 secs examiner is pressing on abdomen.
In what disease states would the JVP remain raised?
Right ventricular failure
Pericardial constriction
Cardiac tamponade
Tricuspid valve disease
What is the abdomen-reflux test actually testing?
The ability of the right heart to deal with an increase in venous return
What are the waveforms identifiable in the JVP?
Peaks: - a wave - c wave - v wave Descents: - x descent - y descent
What does the ‘a’ wave represent?
Right atrial contraction
What are 3 pathological ‘a’ waves and what do they represent?
Prominent when right atrial pressure is raised:
- Pulmonary HTN
- Tricuspid stenosis
Cannon waves (giant) - atrial systole occurs against a closed tricuspid valve
- Complete heart block
Absent
- AF (no atrial systole)
What does the ‘x’ descent represent and in what diseases does it change?
Atrial relaxation
Prominent in:
- Cardiac tamponade
- Constrictive pericarditis
What does the ‘c’ wave represent?
Transmitted pulsation from carotid artery
Marks moment of tricuspid valve closure
Interrupts to ‘x’ descent
What does the ‘v’ wave represent?
Atrial filling while the tricuspid valve is closed (ventricular systole)
When is the ‘v’ wave pathological?
Prominent in tricuspid regurgitation
