Cardio Flashcards
General Inspection
Position
Exposure
Surrounding area - oxygen, medications, drips, monitor
Patient - body habitus, well/unwell, temperature, scars, cyanosed, obvious syndrome (Downs, Marfin’s, Noonans)
Nails
CR (<2 secs) Temp Splinter haemorrhage Koilonychia Clubbing Quninke’s sign
Splinter haemorrhaging
Small streak like bleeds under nail bed >2
Can indicate: Infective endocarditis Rheumatoid arthritis Trauma Sepsis Vasculitis
Koilonychia
Spooning of the nail
Indicates Iron Deficiency Anaemia
Clubbing
Can indicate:
Infective endocarditis
Cyanotic heart disease
Quinke’s sign
RARE
Pulsating nail beds
Indicates SEVERE aortic regurgitation
Temp/colour
Peripheral cyanosis
Peripheral vascular disease
Low cardiac output
Hands
Tar staining (smell of tobacco)
Xanthomata - hyperlipidaemia
Janeway lesions RARE - Non tender lesions on palms
Osler’s node RARER - Red tender nodules on fingers
Pulses
Radial pulse Carotid Radio radial delay Radio femoral delay Collapsing pulse
Radial pulse
Rate - tachy/bradycardia
Rhythm - regular, regularly irregular, irregularly irregular
Character - strong, weak
Carotid pulse
Volume and character
Weak - reduced cardiac output - hypotension, cardiac failure
Bounding - increased cardiac output - sepsis, aortic regurgitation
Corrigan’s sign - visibly exaggerated - aortic regurgitation
Pulses paradoxes - weaker on inspiration - cardiac tamponade, constrictive pericarditis
Radio radial delay
Radio femoral delay
RRD
absence more likely than delay
Aortic dissection, coarctation at the aortic arch
RFD
Coarctation of the aorta
Collapsing pulse
Feel for tapping though muscle bulk of forearm
Lift arm and feel for an increase in the character of the pulse
SEVERE aortic regurgitation
