VENOUS PULSES IN TRICUSPID
Classic neck vein waves in a patient with severe tricuspid insufficiency.
Note the prominent v waves, the nearly absent x descents, and the precipitous fall in the y descents.
The prominent v waves result from the failure of the tricuspid valve to block flow into the right atrium, superior vena cava, and jugular veins during right ventricular systole; this also blunts the x descent.
The precipitous fall in the y descent occurs as blood flows back into the right ventricle unopposed by the tricuspid valve.