From the Research
The jugular venous pulse (JVP) has three main waves: the a wave, c wave, and v wave, with descents including the x and y descents, which are crucial for assessing right heart function and hemodynamics, as supported by the most recent study 1. The a wave represents atrial contraction and occurs just before the first heart sound. The c wave is a small deflection caused by the bulging of the tricuspid valve into the right atrium during early ventricular systole. The v wave represents passive filling of the right atrium against a closed tricuspid valve during ventricular systole. Between these waves are descents:
- the x descent follows the a and c waves, representing atrial relaxation,
- while the y descent follows the v wave, representing rapid ventricular filling when the tricuspid valve opens. Abnormalities in these waves can indicate various cardiac conditions:
- a prominent a wave suggests right ventricular hypertrophy or pulmonary hypertension;
- a cannon a wave indicates AV dissociation;
- and a prominent v wave may indicate tricuspid regurgitation. Examining the JVP waves is valuable for assessing right heart function and can provide important diagnostic information about cardiac hemodynamics without requiring invasive procedures, as highlighted in 1.
The most recent study 1 emphasizes the importance of recognizing JVP descent patterns, including the normal pattern of single x' or x' > y, and abnormal patterns such as x' = y, x' < y, and single y descent alone, which can aid in quick clinical decision-making. This study provides clinical video recordings of JVP to demonstrate key points, making it a valuable resource for clinicians. Overall, understanding the waves and descents of the JVP is essential for assessing right heart function and hemodynamics, and can provide important diagnostic information for various cardiac conditions, as supported by the latest evidence 1.