Abnormal jugular contour (chronic atrial fibrillation)
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 is a recording from a patient with chronic atrial fibrillation. The simultaneously recorded radial arterial flow signals by Doppler provide timing. The initial high frequency squishing noise represents systolic flow in the radial artery. It will correspond to the radial arterial pulse upstroke if the radial arterial pulse is palpated. The rhythm is irregular as expected in atrial fibrillation. The jugular movements show a single descent which occurs out of phase with the systolic noise and comes after. Therefore the descent is diastolic (y descent).

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