A patient's central venous pressure waveform shows a prominent 'cv' wave with obliteration of the 'x' descent. Which valvular abnormality is MOST consistent with this finding?

• A Tricuspid regurgitation ✓
• B Aortic stenosis
• C Mitral stenosis
• D Pulmonary stenosis

Explanation

In tricuspid regurgitation, blood regurgitates into the right atrium during ventricular systole, producing a large systolic 'v' wave that merges with the preceding 'c' wave to form a giant 'cv' wave. The normal 'x' descent (which represents atrial relaxation and tricuspid valve descent) is obliterated because the regurgitant jet fills the atrium during the time the 'x' descent normally occurs. This hallmark CVP waveform change is important for detecting new tricuspid regurgitation or confirming suspected regurgitation in the perioperative setting.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.