Cardiac Physical Exam Flashcards
JVD
More than 7cm above sternal angle
Suggests:
1) R Heart failure
2) pHTN
3) Volume overload
4) Tricuspid regurgitation
5) Pericardial disease
Hepatojugular reflux
1) Fluid overload
2) Impaired RV compliance
Kussmaul’s sign
Increased JVP with inspiration
1) RV infarct
2) Postop cardiac tamponade
3) TR
4) Constrictive pericarditis
Systolic murmurs
1) AS - harsh systolic ejection murmur that radiates to the carotids
2) MR - holosystolic murmur that radiates to the axilla
3) MVP - Midsystolic or late systolic murmur with a preceeding click
4) Flow murmur - very common and does not imply cardiac disease
Diastolic murmurs
ALWAYS ABNORMAL
1) AR - early decrescendo murmur
2) MS - mid to late low pitched murmur
S3 gallop
1) Dilated cardiomyopathy (floppy ventricles)
2) Mitral valve disease
Often normal in younger patients and in high-output states (pregnancy)
S4 gallop
1) HTN
2) Diastolic dysfunction (stiff ventricles)
3) Aortic Stenosis
Usually pathologic but often normal in younger patients and in athletes.
Pulmonary edema
L heart failure (fluid “backs up” into lungs)
Peripheral edema
1) R heart failure and biventricular failure
2) Peripheral venous disease
3) Constrictive pericarditis
4) TR
5) Hepatic disease
6) Lymphedema
7) Nephrotic Syndrome
8) Hypoalbuminemia
9) Drugs
Increased peripheral pulses
1) Compensated aortic regurgitation
2) Coarctation (arms more than legs)
3) PDA
Decreased peripheral pulses
1) Peripheral arterial disease
2) Late stage heart failure
Pulsus paradoxus
Lower systolic BP with inspiration
1) Pericardial tamponade
2) Asthma/COPD
3) Tension pneumo
4) Foreign body in airway
Pulsus alternans
Alternating weak and strong pulses
1) Cardiac tamponade
2) Impaired LV systolic function
Poor prognosis
Pulsus parvus et tardus
Weak and delayed pulse
1) Aortic stenosis
