Carotid venous pressure (JVP): normal waveform
In healthy individuals, the waveshape of the carotid vein can be predicted when the cardiac catheter is placed. Each section reflects changes in the right atrium and carotid venous pressure.
Symptoms related to carotid venous pressure (JVP) was one of the first problems introduced to students studying cardiology and the most important ones. Recognizing and understanding these signs will aid patient care, as well as prepare the knowledge of questions that students and young doctors will be asked clinically.
In healthy individuals, the carotid vein waveform can be predicted with the insertion of the heart catheter (depicted in the figure). Each section reflects changes in the right atrium and carotid venous pressure:
Normal JVP waveform
a - reflects contraction of the right atrium and end-diastole.
c - mark the right ventricle to begin contracting and circulation, causing the tricuspid valve to swell.
x - or 'x-down' occurs when the atria dilate and the tricuspid valve is pulled down toward the tip of the heart.
v - reflects atrial filling pressure after ventricular contraction.
y - or 'y-down' represents ventricular filling after the tricuspid valve opens.
In short, a, c, and v reflect an increase in pressure in the right atrium, and x and y reflect a decrease in pressure in the right atrium. Therefore, keep in mind that often components a and c are too close to a clinical distinction.
With these in mind, anomalies of various components in the waveform can be easily detected.