Cardiovascular examination

Question 1

general inspection

Answer 1

appearance (colour, pain, oedema, dyspnoea)

positioning, level of consciousness

pt surrounding (GTN, O2, cigarettes, ECG)

Question 2

hand inspection

Answer 2

colour, temp

CRT

clubbing, splinter haemorrhages, palmar creases
osler’s nodes, janeway lesions
rheumatoid signs

Question 3

arm & neck inspection

Answer 3

RR
radial pulse (rate, rhythm)
radio-radial delay
radio-femoral delay
collapsing pulse
blood pressure
JVP
carotids (character & volume)

Question 4

face

Answer 4

conjunctivae pallor
malar flush
mouth (tongue, cyanosis) // dental hygiene
syndromes - marfan, down

Question 5

chest inspection

Answer 5

visible pulsatation/heaves
scars
dilated veins

Question 6

palpation

Answer 6

apex
heaves // thrills

Question 7

auscultation

Answer 7

4 areas
axilla for mitral regurgitation
carotid bruits for aortic stenosis

Mitral area rolled onto left lateral position (bell) for murmur of mitral stenosis.

Tricuspid area leaning forward with breath held in expiration – for murmur of aortic regurgitation.

lung bases

Question 8

end pieces

Answer 8

sacral & peripheral oedema

fundoscopy
dipstick & urine
hepatomegaly/splenomegaly