Cardio Flashcards
What do you start the examination with?
Wash hands
Introduce yourself
Identification
Consent patient
What exposure of the patient do you need?
Waist up
What might you look for on general inspection of the bedside?
GTN spray Meds/drips Oxygen Mobility aids Catheter
What 9 things do you look for on inspection of the hands?
Tar staining Temperature Sweating Pallor of palmar creases Peripheral cyanosis Clubbing Splinter haemorrhages Oslers nodes/janeway lesions Tendon Xanthomas
How do you assess radial pulse?
Take both simultaneously
What are you assessing in the radial pulse?
Rate and rythm
What do you assess in the brachial pulse?
Character and volume
How do you perform the test for a waterhammer pulse?
Sharply raise patients arm and feel for tapping through the muscle bulk of the forearm
What do you assess in the carotid pulse?
Character and volume (both sides)
What 3 cardiac signs do you look for in the eyes?
Subconjunctival pallor
Corneal arcus
Xanthelasma
What is a general cardiac sign of the face?
Malar flush (mitral stenosis)
What 3 cardiac signs do you look for in the mouth or lips?
Central cyanosis
Dental caries
High arched palate
What is a high arched palate indicative of?
Marfan’s
How do you check for a raised jvp?
Position patient and look for fluttering pulsation 2-4cm above the sternal angle
What do you look for on inspection of the precordium
Sternotomy scar
Severe pectus excavatum
Severe kyphoscoliosis
Visible cardiac pulsation
What do you do on palpation?
Palpate the apex beat
Parasternal heaves
Thrills
What areas correspond to the different valves?
A = 2nd intercostal left of sternum P = 2nd intercostal right of sternum T = 5th intercostal right of sternum M = 5th intercostal midclavicular
How do you listen for mitral incompetence?
Auscultate the axilla
How do you listen for mitral regurgitation?
Auscultate the apex with the bell with patient rolled 45 to the left
How do you listen for aortic regurgitation?
Sit the patient forward and auscultate 4th/5th intercostal space on left (full expiration)
What else should you do with the patient sat forward?
Assess for sacral oedema
Auscultate lung bases
Where do systolic murmurs radiate to?
The carotids (bell)
What test should be done if ascites is suspected?
Shifting dullness
What other thing should you check for?
Pitting oedema of the ankles
What do you state you would test?
Femoral pulses Blood presure in both arms Lying and standing blood pressure Opthalmoscopy (hypertensive retanopathy) 12 lead ECG
How would you finish the exam
Thank patient
Redress
Wash hands
Report
