Giant A waves caused by pulmonary HTN. There are two clearly discernible descents (X and Y) following the wave, which rules out CV fusion. There is an appearance here that the giant A waves are "intermittent". That is because she also has Kussmaul's sign, causing the A waves to appear more prominent during inspiration, giving the appearance that they are intermittent. A young woman presents with dyspnea and is found to have elevated JVP, a parasternal heave, and a persistently split S2 with a louder second component (P2). What do you see in the venous waveform? What is the underlying diagnosis? Dr. André Mansoor @AndreMansoor - Author of Frameworks for Internal Medicine https://amzn.to/2LmUODZ #AWaves #Giant #PHTN #JVP #Neck #PhysicalExam #Clinical #Video #Cardiology
