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* Prominent x and y descent in pericarditis?
 #846108  
  aalya - 12/06/17 13:11
 
  Can somebody plz reply how prominent descent in JVP comes in pericarditis?Thanks in advance  
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* Re:Prominent x and y descent in pericarditis?
#3354469
  cardio69 - 12/06/17 14:41
 
  https://i.imgur.com/0IohPoF.png  
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* Re:Prominent x and y descent in pericarditis?
#3354819
  aalya - 12/10/17 23:19
 
  Sorry cardio I couldn’t find the answer in that link.plz explain  
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* Re:Prominent x and y descent in pericarditis?
#3354871
  cardio69 - 12/11/17 17:43
 
  In pericarditis, the R atrium going –> R ventricle having fibrous tissue (imagine having hard robber wall around RV) prevent ventricle to expand.
When RV contract & then relaxes (blood leave RA -> RV) IT’s going to go down V->Y very quickly. But ASA that RV fills up there would be no room for that RV to expand -> you get sharp demarcation back on “Y” back up again, so in fact in pericarditis you get VERY SHARP accentuated “Y” descent as it descends from higher than norm RA/P [ aka; square root wave/sign], now X descent becomes a bit accentuated.

 
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* Re:Prominent x and y descent in pericarditis?
#3354972
  aalya - 12/12/17 14:00
 
  @cardio,Thanks for explanation.i understand the pathopysiology but I still don’t understand how they look like?what does it mean(sharp accentuated).i am thinking more down then normal?thank u in advance.  
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* Re:Prominent x and y descent in pericarditis?
#3354977
  cardio69 - 12/12/17 15:16
 
  If you completely understand what I preach & would of draw it would get exactly something like this -> http://cursoenarm.net/UPTODATE/contents/images/f9/63/10228.myextj?title=Jugul...ericarditis

Glad I could help.
 
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* Re:Prominent x and y descent in pericarditis?
#3355150
  aalya - 12/14/17 11:34
 
  Just one thing that is not clear yet,in pericarditis there is not enough room to relax so how x and y waves are accentuates because they form by atrial relaxation?Thank u for help.i google too and watch on you tube but still stuck on this thing?  
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* Re:Prominent x and y descent in pericarditis?
#3355211
  cardio69 - 12/14/17 23:38
 
  @aalya that's why I exp the pathophys earlier & u said u understand it :)
PC the wall of RV glue to what? -> pericardium*
When in diastole RV snap fast, what happens to the wall? -> Outward
So if deep descent Y then suddenly RV cannot fill anymore bz constriction surrounding due to calcified* (here what you think gone happen to Pressure of RA? (here what you think gone happen to Pressure of RA? Goes UP that’s how u get prominent descent pic.
So, think if in diastole (repaid relaxation) & sucking of to RA vol.
 
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* Re:Prominent x and y descent in pericarditis?
#3355212
  cardio69 - 12/14/17 23:44
 
  All you need to recog square root wave/sign "Y" i just dissected here. Forget about x that's not classic to pin down in CP.  
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* Re:Prominent x and y descent in pericarditis?
#3355319
  aalya - 12/15/17 12:54
 
  Thanks a lot.i understand now.  
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* Re:Prominent x and y descent in pericarditis?
#3355412
  cardio69 - 12/16/17 17:23
 
  Welcome.  
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