The New England Journal of Medicine has a great image of the giant 'CV' wave seen in tricuspid regurgitation, which they published in January 2012. Included with the image is a short video. It is absolutely brilliant, and we would strongly recommend reading the case and watching the video. Included with the video of the JVP is the echocardiogram showing severe TR with a dilated RA. The view is foreshortened a bit to demonstrate the right heart clearly. It is seen that the tricuspid valve leaflets fail to coapt, resulting in the severe TR. In addition, though not clearly evident, there is mitral stenosis, likely rheumatic in origin.
Rheumatic heart disease is the primary cause for mitral stenosis. Though uncommon in the western world, it is highly prevalent in India and in other South Asian countries. You may notice this patient is probably from South Asia, given the colour of his skin. Then of course, the authors are doctors from India as well!
Do try to read this article. It is free to access for non-subscribers as well.
For the MRCP exam
Remember everything about the JVP. It is very likely there will be a question regarding it - be it normal waves or abnormal appearances.
Click here to access the article.
Rheumatic heart disease is the primary cause for mitral stenosis. Though uncommon in the western world, it is highly prevalent in India and in other South Asian countries. You may notice this patient is probably from South Asia, given the colour of his skin. Then of course, the authors are doctors from India as well!
Do try to read this article. It is free to access for non-subscribers as well.
For the MRCP exam
Remember everything about the JVP. It is very likely there will be a question regarding it - be it normal waves or abnormal appearances.
Click here to access the article.
I am a medical resident on cardiology and I also wrote a few words about tricuspid valve insufficiency.
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