Cardio Exams Flashcards
what is malar flush and what cardio condition is it associated with?
Mitral stenosis
Plum red discolouration of cheeks
How long should cap refill be done for?
5s
what pulses should be felt in a cardio exam?
Radial + radio radial
Brachial + collapsing pulse
what are 2 causes of a wide pulse pressure?
BP difference >100
Aortic regurg
aortic dissection
what are 3 causes of a narrow pulse pressure?
Bp difference <25
Aortic stenosis
CHF
Cardiac tamponade
what murmur radiates to the carotids?
Aortic stenosis
what murmurs are louder on inspiration?
RIGHT sided
(RILE)
what murmurs are louder on expiration?
LEFT sided
(RILE)
what special test is used to assess aortic regurgitation?
Sit patient forwards
listen at L lower sternal border (T region) during expiration
what manoeuvre extenuates mitral regurgitation?
Roll patient to L side and listen in mitral area - also listen for radiation to axilla
what manoeuvre extenuates mitral stenosis?
Listen with BELL at mitral area with patient rolled to L during expiration
what are 6 further investigations for a cardio exam?
Measure BP
peripheral vascular exam
ECG
urine dip - haematuria w htn
BMs
fundoscopy
what history details are important in fluid balance?
Bleeding
Vomiting
Stools/diarrhoea
Urine output
fever and diaphoresis
Thirst
Eating and drinking status
Symptoms of fluid overload
Fluid restrictions
what should be assessed on examination in a fluid assessment?
Inspection
Peripheral - CRT, Pulses, BP, skin turgor, perfusion, JVP, Face
RR and Heat sounds
Lungs
Abdomen - shifting dullness
Sacral and pedal oedema
what are 5 further assessments that can be done in a fluid assessment?
BP
FBC, U+E
Imaging - CXR, Abdo USS
Take fluid balance
Urine and serum osmolality
what is normal urine osmolality?
500 - 850 mOsm/Kg
what is normal serum osmolality?
275 - 295 mOsm/Kg
