Atrial septal defect (ASD) frequently gives rise to a distinctive pattern of high, peaked jugular V waves which often exceed the A waves in height. Both the X and Y descents are relatively deep. Of 27 patients with ASD and normal pulmonary vascular resistance, 11 (41%) showed a pattern which, in itself, was sufficiently characteristic to be virtually diagnostic of ASD. This pattern generally indicates a fairly large left-to-right shunt and is lost when pulmonary hypertension complicates the picture. With rare exceptions, such a venous pulse was not seen in normal individuals and in patients without ASD.
Tavel ME, Bard RA, Franks LC, Feigenbaum H, Fisch C. The Jugular Venous Pulse in Atrial Septal Defect. Arch Intern Med. 1968;121(6):524–529. doi:10.1001/archinte.1968.03640060038007
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