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Jugular Wave Recognition Breakthrough*: X′ Descent vs the X Descent and Trough

Jules Constant, MD
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*From the State University of New York at Buffalo, Buffalo, NY.

Correspondence to: Jules Constant, MD, 57 Tillinghast Place, Buffalo, NY 14216-3408



Chest. 2000;118(6):1788-1791. doi:10.1378/chest.118.6.1788
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Irrational nomenclature and concentrating on ascents and peaks of waves have made recognition of jugular waves an occult art. By agreeing to call atrial relaxation X and the systolic fall in atrial pressure due to the descent of the base X′, we can begin to teach the easy recognition of jugular contours. Next, it is necessary to realize that the artifacts seen on electronically derived jugular pulse tracings are not to be expected when observing the neck pulsations with the naked eye. Finally, it can be shown that the easiest way to recognize jugular waves is by timing only descents as being either systolic or diastolic according to their relation to either the patient’s radial pulse or heart sounds. It is almost unknown that only a single systolic descent due to the descent of the base is usual in the normal adult jugular.

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