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Year : 2013  |  Volume : 7  |  Issue : 4  |  Page : 482

Abnormal CVP waveform

Department of Cardiac Anaesthesia, Sir Ganga Ram Hospital, New Delhi, India

Correspondence Address:
Monish S Raut
Department of Cardiac Anaesthesia, Sir Ganga Ram Hospital, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1658-354X.121060

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Date of Web Publication7-Nov-2013

How to cite this article:
Raut MS, Maheshwari A. Abnormal CVP waveform. Saudi J Anaesth 2013;7:482

How to cite this URL:
Raut MS, Maheshwari A. Abnormal CVP waveform. Saudi J Anaesth [serial online] 2013 [cited 2022 Jan 26];7:482. Available from:


A 52-year-old male patient was scheduled for coronary artery bypass grafting. Patient's echocardiography findings revealed no tricuspid regurgitation or stenosis with good right ventricular function. Preoperatively central venous line was inserted through right internal jugular vein. After insertion, central venous pressure (CVP) waveform showed abnormal large a-c wave complex ([Figure 1] - marked with red arrow) and CVP value was in the range of 10-12 mm Hg. Such wave pattern may resemble a cannon "a" wave of CVP. [1],[2] Transesophageal echocardiography was done which demonstrated lower end of central venous catheter getting abutted with tricuspid valve early in the systole. This explained the mechanism of such abnormal CVP waveform. When central venous catheter was pulled back at the insertion point, CVP waveform showed normal waves and CVP values was in the range of 4-6 mm Hg [Figure 2]. It is important to ascertain the position of central venous line before interpreting waveform.
Figure 1: Abnormal CVP waveform marked with arrow

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Figure 2: CVP waveform after pulling central venous catheter

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  References Top

1.Barbeito A, Mark JB. Arterial and central venous pressure monitoring. Anesthesiol Clin 2006;24:717-35.  Back to cited text no. 1
2.Rodes A, Grounds RM, Bennett ED. Hemodynamic monitoring. In: Fink MP, Abraham E, Vincent JL, Kochanek PM, editors. Textbook of Critical Care. 5 th ed. Philadelphia, PA: Elsevier Saunders; 2005. p. 736.  Back to cited text no. 2


  [Figure 1], [Figure 2]


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