Cardio Exam

Question 1

What should you inspect in a cardiac exam?

Answer 1

General + bedside
Hands: temp, nails, clubbing, tar, capillary refill
JVP incl hepatojugular reflex
Eyes
Mouth
Chest: scars

Question 2

What should you palpate in a cardiac exam?

Answer 2

Apex beat: fingers horizontally usually 5th intercostal space mid clavic
Parasternal heave: heel of hand parallel to left sternal edge
Thrills: Flats of finger sand palm over each valve location
Pulses: radial, R-R delay, brachial, collapsing pulse (radial), carotid

Question 3

What should you auscultate in a cardiac exam?

Answer 3

Palpate carotid to determine 1st heart sound
Aortic: 2nd intercostal space R sternal edge
Pulmonary: 2nd intercostal L sternal edge
Tricuspid valve: 5th intercostal space L sternal edge
Mitral valve: 5th intercostal midclavic line (apex beat) + ask the to roll onto left and take a breath(switch to bell)
Left axilla (mitral incompetance)
Patient sit forward listen in tricuspid region on held expiration (aortic regurg)
Lung bases (also palpate for sacral oedema)

Question 4

What else would you examine in a cardiac exam?

Answer 4

Hepatomegaly
Shifting dullness if ascites suspected
Peripheral oedema
State would check femoral pulses and synchronicity with radial

Question 5

How would you conclude a cardiac exam?

Answer 5

Blood pressure in both arms then in one for lying and standing
Ophthalmoscopy
Obtain a 12-lead ECG

Question 6

How would you conclude a cardiac exam?

Answer 6

Blood pressure in both arms then in one for lying and standing
Ophthalmoscopy
Obtain a 12-lead ECG