{"id":1678,"date":"2020-05-18T10:06:32","date_gmt":"2020-05-18T17:06:32","guid":{"rendered":"https:\/\/up.physicaldiagnosispdx.com\/up\/?page_id=1678"},"modified":"2021-04-29T22:13:23","modified_gmt":"2021-04-30T05:13:23","slug":"giant-a-wave-2","status":"publish","type":"page","link":"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-multimedia-new\/giant-a-wave-2\/","title":{"rendered":"Giant a Wave"},"content":{"rendered":"
[vc_row css=”.vc_custom_1592016626086{background-color: #fff9f9 !important;}”][vc_column][vc_column_text]The a wave of the jugular venous waveform occurs as a result of right atrial contraction. When there is resistance to right ventricular filling, right atrial contraction generates increased pressure, resulting in giant a waves. These waves occur with every beat, unlike cannon a waves, which usually occur intermittently. Causes of giant a waves include tricuspid stenosis and increased right ventricular end-diastolic pressure from any cause (e.g., pulmonary hypertension).<\/span>
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Patient 1:<\/h1>\n

This patient was admitted to the hospital with recurrent infective endocarditis involving a prosthetic tricuspid valve. On examination, there was a late crescendo diastolic murmur that augmented with inspiration heard over the left lower sternal border, consistent with tricuspid stenosis. These videos demonstrate a jugular venous waveform with giant a waves. When the right atrium contracts against a stenotic tricuspid valve at the end of diastole, it results in an increase in pressure in the right atrium.<\/span><\/p>\n

Video Courtesy of BMJ case reports: “Giant a waves”<\/a><\/span><\/p>\n

*It may be easier to appreciate this video by slowing it down to half speed (click the gear icon in the bottom right corner of the video)[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=”.vc_custom_1592016645004{background-color: #dcd9dd !important;}”][vc_column width=”1\/2″][vc_column_text]\n

Giant a Wave<\/span><\/strong>
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