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So I'm doing the Cardio q's on the Physio section of USMLERx and I got a q which asked which wave on a normal JVP tracing would be most prominently affected in tricuspid regurgitation.... So my options were:
A) A & C
B) A & Y
C) C & X
D) V & Y
So my answer was D, but to my surprise, it was incorrect.... they said the correct answer is C.. which makes no sense... so I opened up my Pathophysiology of Heart Disease textbook by Lilly, and I also made a search on Google about this and my answer seems to be correct to both Lilly's textbook and the many websites that I investigated this information in... here is one them.
From:http://www.rjmatthewsmd.com/Definitions/venous_pulse.htm
Abnormalities of the "v" Wave
The positive, late systolic "v" wave results from the increasing right atrial blood volume during ventricular systole when the tricuspid valve normally is closed. With mild tricuspid regurgitation, the "v" wave becomes more prominent, and when tricuspid regurgitation becomes severe, the prominent "v" wave and the obliteration of the "x" descent results in a single, large positive systolic wave (ventricularization) ( figures203-a and 204 ). Normally the "v" wave is lower in amplitude than the "a" wave in the JVP. In patients with an atrial septal defect, however, the higher left atrial pressure is transmitted to the right atrium and the "a" and "v" waves are often equal in the right atrium and the JVP (figure 203-d). In patients with constrictive pericarditis and sinus rhythm the right atrial "a" and "v" waves may also be equal, but the venous pressure is increased, which is unusual with isolated atrial septal defect. In patients with constrictive pericarditis who are in atrila fibrillation, the "cv" wave is prominent and the "y"descent rapid .
So I really don't know what source is correct... I'm still sold on my knowledge from Lilly's.... what do you guys think?
A) A & C
B) A & Y
C) C & X
D) V & Y
So my answer was D, but to my surprise, it was incorrect.... they said the correct answer is C.. which makes no sense... so I opened up my Pathophysiology of Heart Disease textbook by Lilly, and I also made a search on Google about this and my answer seems to be correct to both Lilly's textbook and the many websites that I investigated this information in... here is one them.
From:http://www.rjmatthewsmd.com/Definitions/venous_pulse.htm
Abnormalities of the "v" Wave
The positive, late systolic "v" wave results from the increasing right atrial blood volume during ventricular systole when the tricuspid valve normally is closed. With mild tricuspid regurgitation, the "v" wave becomes more prominent, and when tricuspid regurgitation becomes severe, the prominent "v" wave and the obliteration of the "x" descent results in a single, large positive systolic wave (ventricularization) ( figures203-a and 204 ). Normally the "v" wave is lower in amplitude than the "a" wave in the JVP. In patients with an atrial septal defect, however, the higher left atrial pressure is transmitted to the right atrium and the "a" and "v" waves are often equal in the right atrium and the JVP (figure 203-d). In patients with constrictive pericarditis and sinus rhythm the right atrial "a" and "v" waves may also be equal, but the venous pressure is increased, which is unusual with isolated atrial septal defect. In patients with constrictive pericarditis who are in atrila fibrillation, the "cv" wave is prominent and the "y"descent rapid .
So I really don't know what source is correct... I'm still sold on my knowledge from Lilly's.... what do you guys think?
