Cardiac Examination

Question 1

Cardiac Examination Order

Answer 1

Inspection, Palpation, Auscultation

Question 2

Cardiac Inspection

Answer 2

Hands
Clubbing
Radial Pulse - Pulse Rate
Radio-Radial Delay
Brachial Pulse - Assess waterhammer (Ask about Pain first).
Eyes
Mouth
Carotid Pulses (one at a time)
JVP
Chest

Question 3

Cardiac Palpation

Answer 3

Thrills - Palpaple Murmurs (Valve Areas)
Heaves - Left Parasternal Area
Apex Beat (5th ICS MCL)

Question 4

Cardiac Auscultation

Answer 4

Diaphragm
- Auscultate the Valve Areas (Time Murmurs with Pulse)
- Auscultate the Left Axilla
- Auscultate 4th ICS Left Parasternum (Aortic Regurg)
Bell
- Auscultate Apex with the patient rolled to the left. (Mitral Stenosis)
- Carotids

Question 5

Cardiac Examination Conclusion

Answer 5

• Auscultate Lung Bases
• Sacral and Ankle Oedema
• Hepatomegaly
• Shifting Dullness
  Offer:
• Femoral Pulses
• Blood Pressure
• Ophthalmoscopy
• 12-Lead ECG
  Thank the Patient and ask them to redress.
  Wash Hands.