Cardio Abnormal Findings

Question 1

JVD

Answer 1

• JVD at 30-45 degree

- elevated R atrial pressure, R-sided HF

Question 2

central cyanosis

Answer 2

• bluish and purple tinge in central areas such as tongue, conjuctivae, inner surface if lips
• inadequate O2 sat or arterial blood because of pulmonary or cardiac disorders (congenital)

Question 3

peripheral cyanosis

Answer 3

bluish or purplish tinge in extremities or in nose and ears

-reduced blood flow r/t HF, vasconstriction, cold environment

Question 4

splinter hemorrhage

Answer 4

small red-black streaks under fingernails

-infective endocarditis

Question 5

clubbing of nail beds

Answer 5

• obliteration of normal angle between base of nail and skin
• endocarditis, congenital defects, prolonged O2 deficiency

Question 6

color changes in extremities with postural change

Answer 6

• pallor, cyan, mottling after limb elevation, dependent rubor (reddish blue discoloration)
• glossy skin
• chronic decreased arterial perfusion

Question 7

ulcers-venous

Answer 7

necrotic crater-like lesion - LE at medial malleolus
-slow wound healing
poor venous return, varicose veins, incompetent venous valves

Question 8

ulcers-arterial

Answer 8

• pale ischemic base, well-defined edges found in toes, heels lateral malleoli
• ateriosclerosis, diabetes

Question 9

varicose veins

Answer 9

• visible dilated, discolored, tortuous vessels in LE

- incompetent calves in vein

Question 10

bounding pulse

Answer 10

• sharp, brisk, pounding pulse
• hyperkinetic states (anxiety, fear)
• anemia
• hyperthyroidsim

Question 11

thready pulse

Answer 11

• waek, slowly rising pulse, easily obliterated by pressure

- blood loss, decreased CO, aortic heart vakve disease, PAD

Question 12

irregular pulse

Answer 12

• regular irregular or irregularly irregular
• skipped beats
• cardiac dysrhythmias

Question 13

pulse alternans

Answer 13

• reg rhythm, but strength of pulse varies with each beat

- HF , cardiac tamponade

Question 14

absent pulse

Answer 14

atherosclerosis, trauma, emboli

Question 15

thrill

Answer 15

• vibration of vessel or chest wall

- aneurysm, aortic regurgitation, arteriovenous fistula

Question 16

tachycardia

Answer 16

• > 100 BPM

- exercise, anxiety, shock, need for increased CO, hyperthyroidism

Question 17

bradycardia

Answer 17

• <60 bpm

- rest/sleep, SA or AV node dmg, athletic conditioning, SE drugs like beta blockers, hypothyroidism

Question 18

displaced PMI

Answer 18

• palpated below 5th ICS and to the left of MCL

- cardiac enlargement as a result of CAD, HF, cardiomyopathy

Question 19

unusually warm extremities

Answer 19

-possible thyrotoxicosis

Question 20

cold extremities

Answer 20

-intermittent claudication, PAD, low CO, severe anemia

Question 21

pitting edema of lower extremities or sacral area

Answer 21

-interruption of venous return to heart, RHF

Question 22

abnormal cap refill

Answer 22

• blanching of nail bed for ≥ 2 sec after release

- possible reduced artery capillary perfusion, anemia

Question 23

asymmetry in limb circumference

Answer 23

-DVT, varicose veins, lymphedema

Question 24

pulse deficit

Answer 24

-cardiac dysrhythmias

Question 25

arterial bruit

Answer 25

turbulent flow sound in peripheral artery

-obstruction arterial or aneurysm

Question 26

third heart sound

Answer 26

• low pitched, heard in early diastole “gallop”

- LHF, volume overload, mitrial, aortic or tricuspid regurgitation, HTN

Question 27

fourth heart sounds

Answer 27

• low pitchedm heard in late diastole, “gallop”

- LV hypertrophy, aortic stenosis, HTN, CAD