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Case Reports
. 2023 Dec 20;7(12):ytad613.
doi: 10.1093/ehjcr/ytad613. eCollection 2023 Dec.

Hummingbird-like cannon a-waves

Hiroto Hayashi  1 , Tatsuya Kawasaki  2 , Chieko Sakai  2 , Satoaki Matoba  3
Affiliations
Case Reports

Hummingbird-like cannon a-waves

Hiroto Hayashi et al. Eur Heart J Case Rep. .
No abstract available

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
(A) The right external jugular vein is distended in the supine position with a pillow (arrows). (B) In the sitting position, skin fluctuation due to the internal jugular venous flapping is noted (arrows; see Supplementary material online, Video S1). (C) The jugular pulse tracing shows a prominent positive wave (arrowhead) and another wave (asterisk), findings consistent with an atrial contraction around QRS (i.e. in the phase of a closed tricuspid valve) and during late systole to early diastole, respectively, although P-waves are indistinct on lead II. (D) Electrocardiography shows a regular narrow complex tachycardia at a rate of 125 b.p.m. without ST-T changes; a P-wave is present ∼200 ms before the following QRS (arrows). (E) After administration of digoxin, follow-up ECG shows an atrial rate of 250 b.p.m. with 2:1 to 4:1 atrial–ventricular conduction, a finding consistent with the diagnosis of atrial tachycardia. (F) Normal sinus rhythm is achieved with electrical cardioversion.
See this image and copyright information in PMC

References

    1. Chua Chiaco JM, Parikh NI, Fergusson DJ. The jugular venous pressure revisited. Cleve Clin J Med 2013;80:638–644. - PMC - PubMed
    1. Sapira JD. Veins. In: Orient JM (ed.), The art and science of bedside diagnosis. 1st ed. Baltimore/Philadelphia/Hong Kong/London/Munich/Sydney/Tokyo: Williams and Wilkins; 1990. p355–370.
    1. Ho CJ, Ho RT. The frog sign revisited. J Innov Card Rhythm Manag 2022;13:5184–5187. - PMC - PubMed

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