Venous pulses in tricuspid insufficiency

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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.