Lung Ultrasound -- New OA-POCUS of the Month episode now available!

This is a challenging question that few people answer correctly! Most anesthesiologists do not know how to interpret a CVP waveform. There are two systolic peaks (c, v) and one diastolic peak (a) in the CVP waveform. A cannon a-wave can be seen during AV dissociation or junctional rhythm because atrial contraction will occur against a closed tricuspid valve, which will transmit a high pressure to the transducer. The c-wave is due to tricuspid bulging resulting from isovolumic ventricular contraction. A tall c-v wave is generally seen in tricuspid regurgitation as their high pressure is transmitted during ventricular systole due to the regurgitant jet filling the right atrium. Tricuspid stenosis would result in a larger than normal a-wave and an abnormal y-descent owing to slowed ventricular filling during diastole.