Large V waves on a CVP tracing are indicative of which condition?

Large V waves on a central venous pressure (CVP) tracing are indicative of tricuspid regurgitation. This condition occurs when the tricuspid valve does not close properly during ventricular contraction, leading to a backflow of blood from the right ventricle into the right atrium. As the right ventricle contracts, the pressure in the atrium increases significantly, which is represented by these pronounced V waves on the CVP tracing.

In tricuspid regurgitation, these V waves are prominent because they reflect the additional volume of blood that is being pushed back into the atrium, hence the larger amplitude. This finding can be observed particularly in conditions that cause volume overload in the right atrium or right ventricle.

In contrast, conditions such as atrial fibrillation, pulmonary embolism, or cardiac tamponade have different physiologic implications that do not produce the same distinctive waveform seen with tricuspid regurgitation. For instance, atrial fibrillation might create an irregular baseline rather than clear V waves, while pulmonary embolism usually leads to a decrease in right heart pressures and is not associated with large V waves. Cardiac tamponade would show more of a blunted tracing due to external pressure restricting