The
Venous
System
181
Fig.
6.2.6:
Simultaneously recorded tricuspid (TA), lead
I1
ECG
(LII), jugular venous
pulse tracing
(VT),
right atrail pressure
(RA)
and jugular venous
flow
velocity in a
subject with mitral stenosis and mitral and tricuspid valve insufficiencies. Atrial
fibrillation and murmur
are
also seen. Note the synchronous ascent and decent of the
right atrial pulse with that of the jugular vein. From Benchimol(l981).
Abnormal filling is particularly relevant in the analysis of venous
pressure and flow waveforms. Figure
6.2.6
illustrates simultaneously
recorded jugular venous pressure and flow velocity waveforms together
with right atria pressure measured in a subject with mitral valve stenosis
and mitral and tricuspid insufficiencies (Benchimol,
198
1).
A sustained
systolic wave and a prominent
v
wave, followed by a rapid
y
decent are
seen on the transcutaneous jugular pulse, as well as the right atrial
pressure tracing. The jugular venous flow waveform also shows an
augmented diastolic wave (D) during the filling phase. The synchronous
ascent and decent of the right atrial pulse with that of the jugular vein can
be observed.
Recordings
of
jugular pressure pulse often utilize tonometer, while
the recording of jugular venous flow uses ultrasound Doppler velocity
probe. The placements of these transducers and the applied pressure are
