Jugular Venous Pressure ( JVP)

The jugular venous pressure (JVP, sometimes referred to as jugular venous pulse) is the indirectly observed pressure over the venous system. It can be useful in the differentiation of different forms of heart and lung disease. Classically three upward deflections and two downward deflections have been described.



The upward deflections are;
- "a" (atrial contraction)
- "c" (ventricular contraction and resulting bulging of tricuspid into the right atrium during isovolumic systole) and
-"v"= atrial venous filling

The downward deflections of the wave are;
-"x"(the atrium relaxes and the tricuspid valve moves downward) during early right ventricular systole
-"y" descent (filling of ventricle after tricuspid opening)

In Exam, all the above will be asked, as they are the basics that all medical student should now, and after succeding in answering them, this they (the examiner) might asked;

# Large 'a' wave (increased atrial contraction pressure)

* tricuspid &/ pulmunory stenosis
* Right heart failure/ Right vntricular hypertrophy
* Pulmonary hypertension

# Cannon 'a' wave (atria contracting against closed tricuspid valve)

* Atrial flutter
* Premature atrial rhythm (or tachycardia)
* third degree heart block
* Ventricular ectopics
* Ventricular tachycardia

# Absent 'a' wave (no unifocal atrial depolarisation)

* atrial fibrillation

# Large 'v' wave (c-v wave)

* Tricuspid regurgitation

# Slow 'y' descent

* Tricuspid stenosis








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