The jugular pulse in pericardial constriction: Its differentiation from that of cardiomyopathy

Lisa, Charles P.; Hood, Gary; Tavel, Morton E.

doi:10.1016/0002-8703(72)90375-4

Cited by 10 publications

(2 citation statements)

References 6 publications

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“…Morphological changes in the jugular pulse can help in the detection of haemodynamic disturbances in the right heart. Right ventricular pressure overload (Luisada, 1954;Gibson and Wood, 1955;Kitchin and Turner, 1964;Wood, 1968), tricuspid valvular disease (Muller and Shillingford, 1954;Gibson and Wood, 1955;Hartnan, 1960;Kitchin and Turner, 1964), atrial septal defect (Reinhold, 1955;Haroutunian et al, 1958;Tavel et al, 1968), and constrictive pericardial disease (Lisa et al, 1972) have been described as having characteristic changes in pulse contour. Recording a simultaneous phonocardiogram has allowed use of the jugular pulse in timing the right-sided third and fourth heart sounds (Tavel, 1972), the closure of the pulmonary valve, and the opening of the tricuspid valve (peak of 'V' wave) to assess the presence and degree of pulmonary hypertension (Hartman, 1960;Bamboa et al, 1965;Burstin, 1967).…”

Section: Discussionmentioning

confidence: 99%

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Clinical assessment of calibrated jugular pulse recording.

Pyhel¹,

Stewart²,

Tavel³

1978

Heart

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suMMARY Calibrated jugular pulse tracings and cardiac catheterisation were performed on 50 consecutive patients with organic heart disease. Twenty normal adults had calibrated jugular pulse tracings and served as controls. The height of the jugular 'A' and 'V' waves was quantified as a percentage of a known displacement, rendering measurements independent of the amplification used in recording technique. A close correlation existed between the size of the calibrated jugular 'A' and 'V' waves and the actual magnitude of the right intra-atrial pressure changes (A wave, r = 0-72; V wave, r = 0.80). Patients who were free of pulmonary hypertension or tricuspid disease had calibrated 'A' and 'V' waves similar in height to the control population. An enlarged 'A' wave was usually associated with conditions restricting flow into the right ventricle. An enlarged 'V' wave generally indicated tricuspid regurgitation. These changes are often subtle and are not apparent in conventional venous tracings or at the bedside. We conclude that the calibrated jugular pulse tracings can accurately separate normal from abnormal venous waves and expand the diagnostic potential of the jugular pulse.

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Section: Discussionmentioning

confidence: 99%

“…Large 'V' waves would also be expected in atrial septal defect and in constrictive pericardial disease (Lisa et al, 1972) and, therefore, might not be separated by calibration from tricuspid regurgitation. Indeed, 2 of the 3 patients with large 'V' waves in the absence of tricuspid regurgitation had these conditions.…”

Section: Discussionmentioning

confidence: 99%