Makindo Medical Notes.com |
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Findings |
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Waveform | Normal Description | Cause |
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a-wave | First positive deflection, occurs during atrial contraction. Lost with AF | Due to atrial contraction pushing blood into the right ventricle. |
c-wave | Small positive deflection after the a-wave. | Caused by the bulging of the tricuspid valve into the right atrium during ventricular contraction. Others say carotid artefact |
x descent | Downward deflection following the c-wave. | Caused by atrial relaxation and downward movement of the tricuspid valve during ventricular systole. |
v-wave | Second positive deflection, occurring late in systole. | Due to passive filling of the right atrium against a closed tricuspid valve. |
y descent | Downward deflection following the v-wave. | Caused by the opening of the tricuspid valve and rapid ventricular filling. |
Pathological Waveform | Description | Cause |
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Canon a-wave | Very large a-wave due to atrium contracting against a closed tricuspid valve. | Occurs in conditions like complete heart block, ventricular tachycardia, and junctional rhythm. |
Absent a-wave | Absence of the a-wave. | Seen in atrial fibrillation where there is no coordinated atrial contraction. |
Prominent v-wave | Increased amplitude of the v-wave. | Common in tricuspid regurgitation, where blood flows back into the right atrium during systole. |
Slow y descent | Prolonged and slow y descent. | Often associated with tricuspid stenosis or right atrial myxoma, causing obstruction to atrial emptying. |
Steep y descent | Rapid and steep y descent. | Seen in conditions like constrictive pericarditis and severe tricuspid regurgitation. |
Rapid x descent | Deep and rapid x descent. | Common in cardiac tamponade where there is rapid atrial relaxation. |
Condition | Description | Common Causes |
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Raised JVP | Abnormally high pressure in the jugular veins. |
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Low JVP | Abnormally low pressure in the jugular veins. |
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