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Examination Findings > Cardiovascular Exam > Flashcards

Cardiovascular Exam Flashcards

1
Q

General Inspection

A 
Body habitus
Well/ unwell
Scars
Breathless
Cyanosed 
Obvious Syndromes e.g. Marfaans, Downs, Noonans
Audible Click of Prosthetic Valve
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2
Q

Splinter Haemorrhages

A

Small streak like bleeds under nail beds.
One/ two are normal
Conditions: infective endocarditis, trauma, sepsis, RA, vasculitis

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3
Q

Clubbing

A

Infective endocarditis, cyanotic heart disease

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4
Q

Koilonychia

A

Spooning of the nails

Iron Deficiency Anaemia

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5
Q

Quincke’s sign

A

Rare- pulsating nail beds

Severe aortic regurgitation

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6
Q

Temperature and Capillary Refill Time

A

Press 5 secs- return of colour in <2 secs

Poor perfusion

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7
Q

Peripheral Cyanosis

A

Peripheral vascular disease, low cardiac output

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8
Q

Nails

A

Splinter haemorrhages
Clubbing
Koilonychia
Qunike’s sign

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9
Q

Hands

A 
Temperature and cap refill 
Tar staining
Xanthomata 
Janeway lesions 
Olser's nodes
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10
Q

Xanthomata

A

Raised Yellow lesions on tendons

Hyperlipidaemia

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11
Q

Janeway Lesions

A

Rare - non tender lesions on palm or finger pulps

Infective endocarditis

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12
Q

Osler’s nodes

A

Super rare - red tender nodules on fingers, hands and feet

Infective endocarditis

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13
Q

Pulses

A 
Radial (rate and rhythm) 
Radio radial delay 
Radiofemoral delay?
Collapsing pulse?
Carotid pulse (volume and character)
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14
Q

Radial pulse

A

Rate and rhythm
Regular, regularly irregular, irregularly irregular
Tachycardia, bradycardia, AF, block, respiratory sinus arrhythmia

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15
Q

Radio- radial delay

A

Absence more likely than delay

aortic dissection and coarctation at the aortic arch

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16
Q

Radio- femoral delay

A

Offer in OSCE

Coarctation of the aorta (narrowing)

17
Q

Collapsing pulse

A

Offer in OSCE
Lift patients arm and feel for pulse
Increase in the strength of the pulse- aortic regurgitation

18
Q

Carotid Pulse

A

Volume and character
Weak (reduced cardiac output) - hypotension, cardiac failure
Bounding (increased cardiac output) - sepsis
Corrigan’s sign (visible exaggerated) - aortic dissection
Pulsus paradoxus (weaker on inspiration) - cardiac tamponade, constrictive pericarditis

19
Q

Face

A

Mallar flush?

De Musset’s sign?

20
Q

Mallar flush

A 
Rosy cheeks 
Mitral stenosis (poor indication as many other causes of flush)
21
Q

De Musset’s sign

A

Head nodding with pulse (rare)

Very severe aortic regurgitation

22
Q

Eyes

A

Xanthelasma
Corneal arcus
Conjunctival pallor

23
Q

Xanthelasma

A

Yellow raised lesions around the eyes

Hypercholesterolaemia

24
Q

Corneal Arcus

A

Yellow ring overlying the iris - only significant if under 50
Hypercholesterolaemia

25
Q

Conjunctival Pallor

A

Anaemia

26
Q

JVP

A

> 4cm visible vertically above the sternal angle

RHF, overload, massive PE, tension pneumothorax, cardiac tamponade, SVC obstruction

27
Q

Thrills

A

4 valve areas

Palpable murmurs - grade 4 or above

28
Q

Parasternal Heave

A

Left sternal edge
Hand lifted off chest wall
right ventricular hypertrophy

29
Q

Apex Beat

A

Tapping- palpable 1st heart sound in severe mitral stenosis
Hyper- dynamic aortic regurgitation
Heaving aortic stenosis
Absent- try tipping patient on to left side before declaring absent. Emphysema, obesity, pericardial effusion, behind the rib (normal), dextrocardia (rare- check right side)

30
Q

Apex with diaphragm

A

Mitral regurgitation - radiation to axilla

Pansystolic

31
Q

Lower left sternal edge with diaphragm

A

Aortic regurgitation (early diastolic), tricuspid regurgitation and pan- systolic murmur of ventricular septal defect

32
Q

2nd intercostal space, left sternal edge with diaphragm

A

Pulmonary stenosis

33
Q

2nd intercostal space, right sternal edge with diaphragm

A

Aortic stenosis (also heard all over precordium)
If murmur heard then listen for radiation to carotids (breath held)
Ejection systolic

34
Q

Carotid bruits

A

Hold breath

Carotid stenosis/ radiation of aortic stenosis

35
Q

Lung bases

A

Crepitations

Left heart failure

36
Q

Sacral oedema

A

Right heart failure

37
Q

Ankle oedema

A

Press into shin for 5 seconds and look for indentation

Right heart failure

Examination Findings (13 decks)

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