Figure 200q The external phonocardiogram and jugular
venous pulse (JVP) tracing are recorded in a patient with severe pulmonary
hypertension. The increased force of right atrial contraction is evident
from the prominent "a" wave in the JVP. The S. is recorded in the fourth
left intercostal space (4LICS) along the lower left sternal border.
Note the increased amplitude of the S4 with inspiration. |