Table 4: Jugular Venous Pulse (JVP)

Physical Finding Associated cardiac condition(s)
JVP >8 centimeters (or >3 centimeters above sternal angle) with patientís head tilted 45% Right heart failure, pericardial effusion/ constrictive pericarditis, tricuspid stenosis, tricuspid regurgitation, fluid overload, superior vena cava obstruction, hyperdynamic circulation
Jugular veins fill during inspiration (Kussmaul's sign) Constrictive pericarditis, corpulmonale, pulmonary embolism, right ventricular infarction, right heart failure, tricuspid stenosis, cardiac tamponade, acute pulmonary hypertension, severe asthma, tension pneumothorax, & exacerbations in chronic obstructive pulmonary disease
Dominant a wave Tricuspid stenosis or atresia, pulmonary stenosis, pulmonary hypertension, right ventricular hypertrophy, right atrial myxoma
Absent a wave Atrial fibrillation
Cannon a wave Complete heart block, paroxysmal atrial tachycardia, ventricular tachycardia, junctional rhythm
Rapid x descent Cardiac tamponade
Dominant v wave Tricuspid regurgitation (as in primary pulmonary hypertension), atrial septal defect (also prominent y descent)
Rapid y descent Constrictive pericarditis, severe right heart failure, severe tricuspid regurgitation
Slow y descent Tricuspid stenosis, right atrial myxoma
Blunted y descent (or x descent more prominent than y descent) Cardiac tamponade