Describe how to Analysis and Evaluation of JVP ?
1) Elevated: Any cause producing right ventricular, failure or in pericardial effusion and in constrictive pericardiitis when prominent and 'v' waves with sharp x and y descents make M or W pattern.
2) Low JVP: Hypovolaemia, excessive diuresis.
3) Tall 'a' Wave: Forceful atrial contraction as in tricuspid stenosis, atrial myxoma increased RV filling pressure - Pulmonary stenosis. Pul hypertension.
4) Cannon 'a' Wave: Atrial contraction during closed a-v valve - complete heart block, 'nodal rhythm7 premature beat, ventricular pacing.
5 ) Absent 'a' Wave: Atrial fibrillation, asystole, flutter.
6) Elevated 'v' Wave: Tricuspid regurgitation, RV failure, restrictive cardiomyopathy.
7) Prominent x Descent: Tainponade, subacute constriction possibly chronic constriction; RV infarction with preserved atrial contractility.
8) Prominent y Descent: Constrictive pericarditis restrictive cardiomyopathy, tricuspid regurgitation.
9) Slowx Descent: Atrial fibrillation.
10) Slow y Descent: Tamponade tricuspid stenosis, so called muscle bound RV in TOF.
11) Kussmaul's Sign: Lack or absence of inspiratory decline in venous pressure round in constrictive pericarditis.
12) Spider Waves: Occasionally in atrial flutter rapid sharp waves are seen at the root of neck like a dancing spider.
13) Except in cases of severe tricuspid regurgitation the venous waves are always better seen than palpated.