Cardio things to remember Flashcards
Cardiovascular exam what does malar flush suggest?
Mitral stenosis
Cardio exam hand signs
- Splinter haemorrhages
- Clubbing
- Colour – dusky bluish discolouration (cyanosis) suggests hypoxia
- Temperature – cool peripheries may suggest poor cardiac output / hypovolaemia
- Sweaty/clammy– can be associated with acute coronary syndrome
- Janeway lesions – non-tender maculopapular erythematous palm pulp lesions – bacterial endocarditis
- Osler’s nodes – tender red nodules on finger pulps / thenar eminence – infective endocarditis
- Tar staining – smoker – risk factor for cardiovascular disease
- Xanthomata – raised yellow lesions – often noted on tendons of wrist – caused by hyperlipidaemia
- Capillary refill time – normal is <2 seconds – if prolonged may suggest hypovolaemia
Where are Janeway lesions and sign of what?
Non-tender maculopapular erythematous palm pulp lesions.
Bacterial endocarditis
Where are Osler’s nodes and sign of?
Tender red nodules on finger pulps / thenar eminence. Infective endocarditis
Collapsing pulse indicates?
Aortic regurg
What characters can a carotid pulse have?
Slow rising (stenosis)
Collapsing (regurg)
Bisferians (mixed)
Raised JVP might indicate
fluid overload / right ventricular failure / tricuspid regurgitation
What is the hepatojugular reflex?
Sustained rise (>/=4cm) in the JVP (longer than 1-2 cardiac cycles) when pressure is applied to the liver. Suggests RV failure or tricuspid regurg.
Why is Marfans relevant to a cardiac exam?
↑ risk of aortic aneurysm/dissection
What would a parasternal heave indicate?
RV hypertrophy
Where does an aortic stenosis murmur radiate to?
Carotids
Where does a mitral regurg murmur radiate to?
Axilla
Cardiovascular exam further investigations?
- Peripheral vascular examination
- Abdominal exam (organomegaly, renal and aortic bruits, femoral pulses, AAA
- Lying and standing BP
- Perform fundoscopy – malignant hypertension – papilloedema
(5. 12 lead ECG??)
