Cardiovascular Exam Flashcards
5 finger method to CV exam
Hx Physical ECG Imaging Lab
Familial clustering is common in pts with ___
Hypertrophic cardiomyopathy
Marfan’s syndrome
Prolonged QT syndrome
CAD
Components of a complete cardiac diagnosis include consideration of ___
Underlying etiology
Anatomic abnormalities
Physiologic distrubance
General appearance on CV exam
Consciousness Cyanosis Flushing Respiratory patterns Anxiety/Distress Body habitus Diaphoresis
Landmarks of a CV exam
Sternal notch and angle Sternal border Mid clavicular line Anterior axillary line Xiphoid process Nipples
Where is the PMI in an upright pt?
5th ICS, 1 cm medial to MCL
Where is the PMI in a supine pt?
4th-5th ICS at mid-clavicular line
When is chest percussion used?
Estimate cardiac size when PMI not detectable
Start far left and move medially to find cardiac “dullness”
How to measure JVP
Place pt in supine position to allow veins to engorge, then raise 30-45 deg
Normal JVP is 0-9
Estimate of CVP and RA pressure
Cuases of JVP/JVD
SVC obstruction Severe heart failure Constrictive pericarditis Cardiac tamponade RV infarction Restrictive cardiomyopathy
Causes of hepatojugular reflex
Poorly compliant RV, RV failure
Constructive pericarditis
Obstructive RV filling by TS or RA tumor
JVP waveforms
A atrium contracting
X descent atrium relaxation and filling, tricuspid closed
V wave - tricuspid valve closed and bulging, tense/full atrium
y descent - atrial emptying
JVP is a good measure of which side of the heart?
Right side
Internal jugular is a better estimate than external
