Make me easy Remember ---CVS Revision - 2
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JVP Waveform:
Table: JVP waveform interpretation
| Waves | Interpretation |
|---|---|
| a | Rt Atrial contraction (Presystolic) |
| x, x' | Atrial relaxation |
| c | upward tricuspid bulge (Coincides with S1) |
| v | Atrial filling (Coincides with S2) |
| y | Atrial emptying (70% of ventricular filling) |
Chart: JVP waveform
Type: Line chart depicting a waveform over time (implied by x-axis).
Main Elements:
* Y-axis represents JVP (implicitly pressure or height).
* X-axis represents time.
* Curve: A series of peaks and troughs.
* Peaks: Labeled A, C, V.
* Troughs: Labeled x, x', y.
* Vertical lines with labels: "Mitral valve closure" and "Aortic valve closure" are marked below the x-axis.
* Points: Specific points on the curve are labeled A, C, V, x, x', y. The peak A is above x, the peak C is above x', and the peak V is above y.
* Annotation: "------ Active space ------" is present to the right of the chart.
Abnormalities:
Table: Abnormal JVP waves and associated conditions
| Abnormal wave | Condition |
|---|---|
| a wave | 1. Prominent | Tricuspid valve obstruction/RVH/Pulm HTN |
| | 2. Giant/Cannon | AVNRT/Junctional rhythm/Complete heart block/VT with AV dissociation |
| | 3. Absent | A-fib/Hyperkalemia |
| x descent | Prominent/Rapid | Cardiac tamponade/RCM/Chronic constrictive pericarditis (CCP) |
| | Absent | Tricuspid regurgitation (TR)/RV failure |
| v waves | Diminished | Hypovolemia |
| | Prominent | ↑ vena cava pressure : CCP/RV failure |
| | | 2nd route : ASD/TR (Lancisi sign) |
| y descent | Prominent | CCP |
| | Slow | Tricuspid stenosis (TS) |
Kussmaul's sign:
* Inspiration → ↑JVP.
* Causes: CCP/RCM/TS/RV MI.
* Not seen in cardiac tamponade.
Abdominojugular reflex: > 3cm/ > 15s → Impending right heart failure.
Heart Sounds
Box: Low pitched heart sounds
* S3
* S4
* Tumour plop
Box: Low pitched murmurs
* MS
* TS
* Austin Flint murmur
A. S1:
* Cause : Closure of AV valves.
* Occurrence : Atrial contraction → (S1) → Isovolumetric contraction.
* Loud S1 : MS.
* Soft S1 : AR, MR, Good filling of the heart.
Timer: 00:34:40
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The JVP waveform is a crucial diagnostic tool in cardiology. It consists of five main components: the a wave represents atrial contraction, the c wave shows tricuspid valve bulging, and the v wave indicates atrial filling. The x descent reflects atrial relaxation, while the y descent shows atrial emptying. Understanding these components helps assess right heart function.
Abnormal JVP waves provide crucial diagnostic information. Giant a waves occur in complete heart block when atria contract against closed tricuspid valves. Absent a waves are seen in atrial fibrillation. Prominent v waves indicate tricuspid regurgitation, while absent x descent suggests RV failure. Prominent y descent points to constrictive pericarditis, and slow y descent indicates tricuspid stenosis.