You are incorrect - our patient's jugular venous pulse wave form shows a dominant "a" wave and a smaller "v" wave.


Your choice: Giant "a," smaller "v"

An abnormally prominent or giant “a” wave is due to enhanced right atrial contraction against an increased resistance. This is most often due to right ventricular hypertrophy. In the video, note the giant “a” wave occurs just before the carotid impulse. The cotton swab reflects the carotid impulse.

Giant 'a'