A waves and distended jugular vien

[1mommy6]

I had a mehanical aortic valve replacment in march.  this year due to a bicuspid valve with severe stenosis.
I have chronic high output heart failure due to severe anemia.I went to a routine Dr.appt and he was onerned at the visible A waves and incresed gular pressur with distention.What is the significance of this asI have never heard of A waves.

[kenkeith]

QUOTE:...visible A waves and incresed gular pressur with distention.What is the significance

>>>>>I don't know the significance of valve replacement, but the issues if any seem to be related to the heart's right side.The ‘a’ wave corresponds to atrial contraction and ends synchronously with the carotid artery pulse. The peak of the 'a' wave indicates the end of atrial systole (pumping phase)..

For some insight the normal jugular venous pulse (JVP) reflects phasic pressure changes in the right atrium and consists of three positive waves and to negative troughs As related to the heart's heartbeat the "a" wave is produced by right side contraction of the atrium.  The positive presystolic "a" wave is produced by right atrial contraction and is the dominant wave in the JVP particularly during inspiration. During atrial relaxation, the venous pulse descends from the summit. The indication is larger filling volume the hgher the higher the wave will be.

"An elevated JVP is the classic sign of venous hypertension (e.g. right-sided heart failure). JVP elevation can be visualized as jugular venous distension, whereby the JVP is visualized at a level of the neck that is higher than normal. The paradoxical increase of the JVP with inspiration (instead of the expected decrease) is referred to as the Kussmaul sign, and indicates impaired filling of the right ventricle. The differential diagnosis of Kussmaul's sign includes constrictive pericarditis, restrictive cardiomyopathy, pericardial effusion, and severe right-sided heart failure".
The jugular venous pressure (JVP, sometimes referred to as jugular venous pulse) is the indirectly observed pressure over the venous system. It can be useful in the differentiation of different forms of heart and lung disease.

Hope this helps, and if you have any further quesions or comments you are welcome to reapond.  Thanks for sharing, take care.