Abnormal jugular contours (postoperative period of coronary bypass grafting surgery)
by Franklin B Saksena, Ranganathan Narasimhan, Sivaciyan Vahe

The Art and Science of Cardiac Physical Examination (With Heart Sounds, Jugular and Precordial Pulsations)

by Narasimhan Ranganathan, Vahe Sivaciyan, Franklin B Saksena
About Video

This video from a patient in the postoperative period of coronary bypass grafting surgery. The movements of the internal jugular venous pulsations are clearly seen over the sternomastoid muscle and the skin overlying the same. The simultaneously recorded heart sounds show a clearly audible louder S2 and a poorly heard S1 for each cardiac cycle. One can see clearly gentle oscillations with two downward movements for each cardiac cycle. One of the movements coincides with the timing of the second heart sound (x' descent). The second one comes after it (y descent). Both the downward movements appear to be equal. The jugular contour therefore will be x' = y descent.

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