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Four common types of venous wave forms observed during Doppler sonography: triphasic, biphasic, monophasic and flat. The A-deflection represents retrograde flow of venous blood from the heart into the vena cava during atrial contraction, in a close time relationship with the electrocardiography P-wave. The X- and Y-deflections represent forward venous flow caused by atrial and ventricular diastole respectively. V represents the opening of the tricuspid valve.
