The true venous pulse wave, central and peripheral

Abstract

The classic jugular phlebogram is a complex composite wave of arterial and venous origin. Mackenzie 5 suggested that, if the arterial components could be removed, we should have what he termed a “true venous pulse wave.” Methods are described whereby the “true venous pulse” can be recorded indirectly from a central and peripheral site. The basis of the procedures is to differentially subtract the arterial volume pulse from the complex of arterial and venous volume pulsations. A comparison was made of the venous pulses and the pressure pulses recorded directly from right atrial catheterization and peripheral venipuncture. When the “true venous pulse” (TVP) is compared with the classic jugular phlebogram (JP), the most obvious difference is the reduction in size of the ‘c’ wave which occurs early in systole. The ‘v,’ ‘h,’ and ‘a’ waves are prominently displayed on a more rapidly rising base line. The negative wave X 1 is more obvious, with a rapidly descending slope from the summit of the ‘c’ wave.