Abnormal jugular contour (patient with post mitral commissurotomy)
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 is a recording from a patient post mitral commissurotomy. The simultaneous recording of the radial arterial flow signals by Doppler provides timing. The initial high frequency swishing noise represents the systolic flow in the radial artery. The descents in the jugulars are visible over the sternomastoid. Two descents are easily seen one coinciding with systolic noise and one that comes after and hence diastolic. The descent in systole appears to be prominent. Thus the x' descent is good indicating good right ventricular function. The y descent is also relatively good and almost equal although at times a little less than the x' descent. The contour is consistent with a post cardiac surgery status. From the level of the top of the venous pulsations, one can measure the jugular venous pressure. The vertical height of the top of the venous pulsations in cm measured from the sternal angle of Lewis will be the jugular venous pressure.

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