Cardiovascular Flashcards
What do you look for in a general observation of the patient?
Cyanosis, breathlessness, distress/demeanour, sweating, body habitus (build), body mass, Marfan’s and other syndromes.
What do you look for in the hands?
Clubbing, splinter haemorrhages, skin temp, tremor.
What do you check on the arm?
Pulse and blood pressure.
What do you look for in the neck?
JVP, carotid pulse/bruits.
What do you look for in the face?
Pallor, central cyanosis, malar flush, corneal arcus, xanthomata.
What causes malar flush and why?
Mitral stenosis due to resulting CO2 retention and vasodilatory effect.
What do you look for in the eyes?
Hypertensive retinopathy, diabetic retinopathy.
What do you look for when you inspect the precordium?
Scars, pacemaker sites.
What do you palpate for in the precordium?
Apex beat, heaves and thrills.
What are you listening for at the lung bases?
Crackles (pulmonary oedema), pleural effusion.
What do you listen for in the legs?
Femoral bruits.
Other than pulses, what do you look for in the legs?
Ankle oedema, leg ulcers, colour, hair, amputations.
Describe the full cardiovascular exam.
Wash hands and introduce yourself -> inspect end of bed -> check hands -> check pulses (radial and carotid) -> check blood pressure -> check JVP -> check head -> inspect precordium -> palpate for heaves, thrills and apex beat -> auscultate precordium (diaphragm and bell) -> auscultate carotids -> inspect lower limbs -> take lower limb pulses -> check leg temp -> look between toes -> cap refill time -> check for oedema -> buergers test -> thank patient.
