Cardio Exam

Question 1

General examination from afar findings

Answer 1

ECG
Oxygen
Tachypnoea
Medications

Signs of congenital disease eg Marfans, Down syndrome

Question 2

Hand findings

Answer 2

• Tar staining
• Arachnodactyly
• Clubbing - ConHD, IE
• Splinter haemorrhages
• Janeway lesions
• Oslers nodes
• Tendon Xanthoma

Question 3

Radial pulse

Answer 3

• Rate
• Rhythm - regularly regular, irregularly irregular (AF), regularly irregular (eg Bigeminy)
• Collapsing pulse - no need to move arm, raised pulse pressure so feels like pulse is thumping against fingers - sign of aortic regurge

Question 4

Carotid pulse

Answer 4

• Can feel with thumb just beyond thyroid cartilage
• Feel for slow rising pulse of aortic stenosis
• Will be low volume if stenosis, will be normal volume but slow rising if beta blocker is mimicking

Question 5

JVP - what can it tell us

Answer 5

• If raised but just moving horizontally - shows high pressure in RA so potential fluid overload
• If raised but moving upwards - sign of tricuspid regurgitation as pressure is being transmitted back up internal jugular vein