Giant 'a' waves in JVP occur in all except -

Because Tricuspid stenosis usually occurs in the presence of other obvious valvulardisease, the diagnosis may be missed unless it is considered. SevereTS is associated with marked hepatic congestion, often resultingin cirrhosis, jaundice, serious malnutrition, anasarca, and ascites.Congestive hepatomegaly and, in cases of severe tricuspid valvedisease, splenomegaly are present. The jugular veins are distended,and in patients with sinus rhythm there may be giant a waves. Thev waves are less conspicuous, and because tricuspid obstructionimpedes RA emptying during diastole, there is a slow y descent.In patients with sinus rhythm there may be prominent presystolicpulsations of the enlarged liver as well. Harrison's principle of internal medicine,18th edition,pg no.1946