Next, we shall evaluate our patient's jugular venous pulse, both the central venous pressure and the wave form. First, we identify the jugular venous pulse here at the inferolateral aspect of the sternocleidomastoid. It is pulsating just about at the same level as the sternal angle, and the sternal angle represents approximately 5 cm of water, and that is a normal central venous pressure.

Now, we'll evaluate the wave form. Let's use the cotton swab and place it on the carotid vessel, so that there is a timing mechanism. Let's everyone look together and see the contour of the jugular venous pulse. [Cut-away]

You could clearly see there was a wave just before the carotid, the "a" wave, and a smaller one just after the carotid, the "v" wave. This is a normal jugular venous impulse. The pattern is entirely normal, and one would expect that in this clinical setting. Patients with anterior wall infarctions most often have normal jugular venous pulse wave form. In those few cases when the jugular venous pulse wave form is abnormal, it often is because there is involvement or extension of infarction to the right ventricle. In this case, we found the expected, a normal venous pressure, a normal venous wave form.