Normal Jugular Pulse Contours

1. What is the difference between the jugular and right atrial pulse contours?

ANS: None for all practical purposes, except when jugular pulse tracings pick up carotid artifacts. Therefore, the right atrial contours will be explained first because it is right atrial events that produce the jugular contours.

2. What is the normal right atrial contour and what are the letters given to the important crests and descents?

ANS: The normal right atrial contours consist of A, C, V, and H waves. However, it is also important to explain the descents, which should be called X, X prime (X'), and Y.

Jugular Pulse
Right atrial pressure pulse waves. This is similar to what is recorded on a jugular pulse tracing.


Radial pulse

Radial pulse

Because the X descent due to atrial relaxation is so small, the dominant descent during ventricular systole is the X' descent.

Si S2

3. What does the eye see on the neck of a normal adult? How does it differ from a jugular pulse tracing?

ANS: One systolic descent simultaneous with a radial pulse and falling on to the S2. The C wave is not seen and the V wave and Y descent may be so small that they are not perceived. The systolic descent is mostly the X' or descent of the base effect.

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