Step I V and Y waves

[Sharkanatomist]

why X wave disappears in regurgitation while it is prominent in insufficiency(Arent' those same?
and also can anyone explain why Y disappears in tamponade while it is more prominent in constrictirve pericarditis?

 

[Jabbed]

Regurgitation and insufficiency are synonymous. This might be a nomenclature issue as the "giant c-v" wave could easily be referred to as a "giant c wave with absent v wave". AFAIK though the accepted terminology is giant c-v wave with tricuspid regurg/insuffiency.

The hallmark of pericardial tamponade is equalization of four chamber pressures during diastole due to DYNAMIC compression of the heart. No pressure gradient = no flow = absent y wave.

Constrictive pericarditis produces STATIC compression of the heart which in effect limits ventricular volumes. Lower volumes = rapid pressure equalization = steep y wave. The pressure tracing is usually described as a "square root" sign.

 

[Sharkanatomist]

but if in both cases the main thing is equalzetion of pressures(one dynamic,other static),if rapid pressure equilization=steep y wave, then shouldn't it be steep in cardiac tamponade too?
and on absent X descent , in first aid it is written that it is absent in tricuspid regurgitation but is more prominen with HF and tricuspid insufficiency,So how? every resource i read equilibrates regurg=insufficiency, i get why wave is absent in regurgitation i just don't get why it is more prominent with insufficiency

 

[6FFF]

The pathophys teaching at my school must be horse **** because we never learned any of that. Is this type of stuff asked on step 1?


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[Sharkanatomist]

well JVP curve can be tested and changes in different conditions

 

[Jabbed]

but if in both cases the main thing is equalzetion of pressures(one dynamic,other static),if rapid pressure equilization=steep y wave, then shouldn't it be steep in cardiac tamponade too?
and on absent X descent , in first aid it is written that it is absent in tricuspid regurgitation but is more prominen with HF and tricuspid insufficiency,So how? every resource i read equilibrates regurg=insufficiency, i get why wave is absent in regurgitation i just don't get why it is more prominent with insufficiency

The difference is that there is not flow during diastole with true tamponade as you are never able to establish a pressure gradient during diastole, hence no y descent. With constrictive pericarditis, you are able to establish a gradient, it's just rapidly expended, hence the steep y descent.

I misread your initial question as I thought you were asking about the v wave and not the x descent. Not sure why FA is making a distinction between regurg and insufficiency as I've always read them to be synonymous.