Cardiovascular exam Flashcards
1
Q
CV exam: General inspection
A
- Well/unwell
- Distressed?
- Body habitus
- Dysmorphic features
- Down’s
- Turner’s
- DiGeorge
2
Q
CV exam: Hands
A
- Inspection
- Clubbing (cyanotic congenital heart disease)
- Peripheral cyanosis
- Endocarditis
- Splinter haemorrhages
- Janeway lesions (non-tender)
- Osler’s nodes (tender)
- Palpation
- Capillary refill
- Pulse
- Rate
- Rhythm
- Volume
- Full
- Thready (hypovolaemia)
- Character
- Collapsing pulse (PDA)
- Slow rising pulse (ventricular outflow obstruction)
- Radial/Radial delay (coarctation)
- Radial/femoral delay (offer)
- Blood pressure (offer)
3
Q
CV exam: Face & neck
A
- Inspection
- Conjunctival pallor
- Scleral icterus (haemolytic anaemia)
- Central cyanosis
- Hydration status (moist mucous membranes)
- Palpation
- Carotid pulse
- Rate, rhythm, volume, character
- JVP (often not done in children < 8 years)
- Biphasic
- Changes with position
- Increases with AJR
- Changes with respiration
- Non-palpable
- Obliterable
- Carotid pulse
4
Q
CV exam: Chest - Inspection
A
- Precordial bulge (cardiomegaly)
- Visible ventricular impulse (thin/hypertrophy)
- Scars
5
Q
CV exam: Chest - Palpation
A
- Apex beat
- Infants/toddlers
- 4th intercostal space, midclavicular line
- Older children
- 5th intercostal space, midclavicular line
- Impalpable
- Dextrocardia
- Pericardial effusion
- Infants/toddlers
- Heaves and thrills
- Hepatomegaly (palpate/percuss)
6
Q
CV exam: Auscultate
A
- PULSE
- 4 valve areas with diaphragm and bell
- Auscultate the axilla and **back **
- InnoSent murmurs
- aSymptomatic
- Systolic
- Soft
- ↑ when Supine
- No radiation
- Pathological murmurs
- Coarctation
- Ejection systolic murmur radiating between the shoulder blades
- Femoral pulses weak/absent
- PDA
- Continuous ‘machinery’ murmur
- Coarctation
7
Q
CV exam: Complete examination
A
- Plot height and weight on the growth chart
- Measure blood pressure
- Check femoral pulses
- ECG/Echo
