# The nurse observes a ______ pattern in the neck veins, showing rapid x and y descents, typical of constrictive pericarditis.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=168419  
> language: ko  
> subject: Diseases of the circulatory system

## 문제

The nurse observes a ______ pattern in the neck veins, showing rapid x and y descents, typical of constrictive pericarditis.

## 보기

1. W **✔ 정답**
2. M
3. V
4. U
5. K

**정답: 1**

## 해설

A W pattern in jugular venous pulsations, characterized by prominent and rapid x and y descents, is a classical sign of constrictive pericarditis. This pattern reflects the rapid early diastolic filling followed by sudden cessation due to the rigid pericardium.

## 임상 시나리오

Jugular Venous Waveform Patterns:

1. W pattern
- Characteristic of constrictive pericarditis
- Shows rapid x and y descents
- Indicates restricted ventricular filling

2. Normal JVP components:
- a wave: atrial contraction
- c wave: tricuspid bulging
- x descent: atrial relaxation
- v wave: venous filling
- y descent: ventricular filling

3. Clinical significance:
- Elevated JVP: right heart failure
- Kussmaul's sign: paradoxical rise with inspiration
- Cannon a waves: AV dissociation
- Prominent v waves: tricuspid regurgitation

4. Constrictive pericarditis features:
- Thickened pericardium
- Impaired diastolic filling
- Equalization of diastolic pressures
- Pericardial knock
- Ventricular interdependence

## 핵심 개념

- **W pattern** — A waveform pattern seen in jugular venous pulsations characterized by sharp descents, typically indicating constrictive pericarditis
- **M pattern** — A waveform pattern showing two peaks of similar height, resembling the letter M
- **V pattern** — A waveform pattern showing a single sharp downward deflection followed by rapid upstroke
- **U pattern** — A waveform pattern showing a rounded bottom curve resembling the letter U
- **K pattern** — A waveform pattern showing sharp angular deflections resembling the letter K

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