Abnormal jugular contours (chronic constrictive pericarditis)
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
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This clip from a patient with chronic constrictive pericarditis. The patient is sitting upright. The jugular pulsations show two distinct and rapid descents for each cardiac cycle. Both of the descents appear equally prominent. The first of the pair occurs at the time of the second heart sound as shown by the sound recording. The jugular contour is x'=y, and therefore abnormal. The venous pressure is obviously elevated.

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