The Jugular Venous Pulse

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The jugular venous pulse is elevated under two widely divergent physiologic circumstances. The first and most

Figure 27-10

Physical appearance of a 15-month-old boy with complete transposition of the great arteries. Birth weight was 9 pounds 2 ounces. The child's head is large, although his body and arms have lost the robust appearance with which he was born.

Figure 27-10

Physical appearance of a 15-month-old boy with complete transposition of the great arteries. Birth weight was 9 pounds 2 ounces. The child's head is large, although his body and arms have lost the robust appearance with which he was born.

Aorta

Aorta

Figure 27-11

Aortic and femoral artery pulses (FA) from a deeply cyanosed 15-month-old boy with complete transposition of the great arteries, a ventricular septal defect, and severe pulmonary stenosis. The pulse pressure is wide because the diastolic pressure is low. The rate of the rise is brisk, and the aortic pulse (upper arrow) is bisferiens (twin peaked).

Figure 27-11

Aortic and femoral artery pulses (FA) from a deeply cyanosed 15-month-old boy with complete transposition of the great arteries, a ventricular septal defect, and severe pulmonary stenosis. The pulse pressure is wide because the diastolic pressure is low. The rate of the rise is brisk, and the aortic pulse (upper arrow) is bisferiens (twin peaked).

common is congestive heart failure that accompanies a nonrestrictive ventricular septal defect with low pulmonary vascular resistance. The second circumstance is right ventricular failure in deeply cyanotic patients with a large volume of unsaturated blood recirculating through the right ventricle and right atrium (Fig. 27-12).

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