Is this TR? If so then very bradycardic! Could this be respiratory variation? Not sure if prox->distal filling could be caused by resp variation alone... either way very incompetent venous valves. Interesting! @VivekKulkarniMD
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Awesome.
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So cool!
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mind. blown.
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Is this case verified by echo or something? For me it looks much more like Kussmaul sign in constrictive pericarditis. Rate is too slow for heart. Patient with such degree of TR and HR of 20-25 hardly would be able to get up hands.
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One can have Kussmaul physiology in severe tricuspid reguritation. May be it is Kussmaul sign in severe TR and not retrograde venous pulse?
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Had a patient like this in the CCU, put a central line in them and freaked when it started pulsating. Thought I hit carotid though I clearly saw it in the ultrasound as being in the IJ. Finished the procedure, got a CXR and a blood gas to be 100% sure. It was impressive!
Thanks. Twitter will use this to make your timeline better. UndoUndo
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Omg, what was the heart rate!
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Or respiratory rate??? Maybe respiratory variation?
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