JVP Interpretation

Question 1

What does the A Wave signify (1)

Answer 1

1. Atrial Contraction

Question 1

List the Waves in JVP in order (5)

Answer 1

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

Question 2

What does the C Wave Signify (1)

Answer 2

1. Closure of tricuspid

not usually visible

Question 3

What does the X descent signify (1)

Answer 3

1. Fall in atrial pressure due to ventricular systole

Question 4

What does the V Wave signify (1)

Answer 4

1. Passive filling of atria agaisnt a closed tricuspid

Question 5

What does the Y descent Signify? (1)

Answer 5

1. Opening of the tricuspid valve

Question 6

What does the JVP represent? (3)

Answer 6

1. Right Atrial pressures
2. Tricuspid valve function
3. Fluid overload status
4. Constrictive pericarditis - kussmaul’s sign = rise in JVP during inspiration
5. SVC obstruction if non-pulsatile

Question 7

Define Kussmaul’s Sign and give cause (2)

Answer 7

1. Paradoxical Raise in JVP on inspiration

Caused by:
2. Cosntrictive Pericarditis

Question 8

What causes a Non-pulsatile JVP (1)

Answer 8

1. SVC Obstruction

Question 9

What causes a large A Wave?

(1 general cause, 3 specific breakdown causes)

Answer 9

1. Increased right atrial pressure

eg
2. Tricuspid stenosis

3. Pulmonary stenosis
4. Pulmonary HTN

Question 10

What causes an Absent A Wave in JVP? (1)

Answer 10

1. AFib

Question 11

What causes “Cannon A Waves” (5)

Answer 11

1. Atrial contractions against a closed tricuspid

eg
2. Complete heart block

3. VT or Ventricular ectopics
4. Nodal rhythms
5. Single chamber ventricular pacing

Think in each of these you have a mismatch of coordination of systole so atria will fire out of time with ventricles and thus be hitting a closed tricuspid as the vent pressure will keep it shut.

Question 12

What causes Giant V Waves (1)

Answer 12

1. Tricuspid Regurgitation

obviously, as it will increase right atrial pressure and push up the fluid back up into SVC as ventricles contract and blood regurges back into the atria