10. Central Venous Pressure (CVP) ???? CVS Physiology for NEET PG/FMGE/USMLE by Dr. Sree Teja

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Central Venous Pressure (CVP) ???? CVS Physiology for NEET PG/FMGE/USMLE by Dr. Sree Teja

Central Venous Pressure (CVP) is the pressure within the thoracic vena cava near the right atrium, and it serves as an essential clinical indicator of right ventricular preload and venous return. It essentially reflects the right atrial pressure and provides crucial insights into cardiac function, circulating blood volume, and intrathoracic pressure dynamics. The normal CVP value ranges from 2 to 8 mmHg, and it fluctuates with changes in posture, respiration, and volume status. CVP is measured via a central venous catheter, typically inserted into the internal jugular or subclavian vein, and positioned near the SVC-RA junction. It plays a pivotal role in critical care, shock assessment, and fluid resuscitation protocols. A raised CVP can be observed in right heart failure, pulmonary hypertension, cardiac tamponade, tricuspid stenosis, or fluid overload, whereas low CVP suggests hypovolemia or distributive shock. CVP waveform analysis includes key components: the a wave (atrial contraction), c wave (bulging of tricuspid valve during RV contraction), v wave (venous filling of RA), and descents like x (atrial relaxation) and y (rapid ventricular filling). This waveform helps distinguish various cardiac pathologies. CVP also interacts with respiratory phases — it typically decreases during inspiration due to enhanced venous return, but paradoxical elevation during inspiration is seen in Kussmaul’s sign, indicating right heart dysfunction. Mastering CVP is foundational for interpreting hemodynamic states and optimizing care in ICU, emergency medicine, anesthesia, and cardiology. ????????????

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Cardiology
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