Question

A patient presented with cold skin, fatigue, shortness of breath with activity and enlarged liver. His JVP was measured which showed higher amplitude of “a” wave JVP is due to

• A. Tricuspid Regurgitation
• B. Tricuspid Stenosis
• C. Mitral Regurgitation
• D. Mitral Stenosis

Answer 1

The Correct Option is B

The patient presents with symptoms suggesting right heart involvement, specifically indicating venous congestion. In the context of Jugular Venous Pressure (JVP) analysis:

• The "a" wave in the JVP waveform represents atrial contraction and is affected when there is an increase in resistance to right ventricular filling.
• Of the options given, Tricuspid Stenosis is characterized by the obstruction of blood flow from the right atrium to the right ventricle during diastole.
• This obstruction results in a higher amplitude "a" wave due to increased atrial contraction against the stenotic tricuspid valve.

Condition	JVP Features
Tricuspid Regurgitation	Prominent "v" wave
Tricuspid Stenosis	High amplitude "a" wave
Mitral Regurgitation	Left heart involvement, no specific JVP feature
Mitral Stenosis	Left heart involvement, no specific JVP feature

Therefore, the higher amplitude "a" wave observed in this patient’s JVP is due to Tricuspid Stenosis.