Giant&;a&;wave in JVP is seen in-: (A) Junctional rhyth, (B) Tricuspid regulation, (C) Complete hea block, (D) Tricuspid stenosis
Answer is D. in Tricuspid stenosis The jugular veins are distended, and in patients with sinus rhythm there may be giant a waves. The v waves are less conspicuous, and because tricuspid obstruction impedes RA emptying during diastole, there is a slow y descent. In patients with sinus rhythm there may be prominent presystolic pulsations of the enlarged liver as well. ( Harrison&;s principle of internal medicine,18th edition,pg no.1946 )