Cardiovascular Examination Flashcards
What signs of CVD do you look for in the hands?
- colour of hands e.g. blue or pale
- tar staining
- clubbing
- janeway (painless) lesions
- osler’s nodes (painful)
- Splinter haemorrhages
- Temperature of both hands, equal?
- capillary refill time
- fine tremor
What signs of CVD do you look for in the arms?
- compare both pulse, radial radial delay
- pulse rhythm
- pulse rate
- pulse strength
- collapsing pulse
- track marks
- brachial pulse
What signs of CVD do you look for in the face?
- colour, pallor or sweating or flush
xanthlasthma or conceal arcus
Hyperlipidemia of pallor of the conjunctivae - blue discolouration of the mouth, lips and tongue
- angular stomatitis
What signs of CVD are you looking for in the neck?
Patient must be lying at 45 degrees
- identify double pulsation of JVP and measure height from sternal angle, should be less that 4 fingers
What signs of CVD do you inspect for in the anterior chest?
- scars
- deformities in bone
- visible pulsations
- skin rashes
What signs of CVD do you palpate for in the anterior chest?
- find apex beat, has it moved?
- Ventricular heave
- thrills
What signs of CVD do you auscultate for in the anterior chest?
Listen in all 4 areas with both bell and diaphragm of whilst holding radial pulse
- murmures
- listen to carotid for bruitis
- listen over apex and round to axillary for mitral stenosis and diastolic murmur whilst turning patient towards the left
Diastolic murmur due to aortic regurgitation by patient sitting forward, listen along sternum on the left
- listen to both carotid arteries
What signs of CVD do you look for on the posterior chest?
- ausculte lungs for crackles that indicate pulmonary oedema
- palpate for sacral odema
What are Janeway lesions, Osler’s nodes and splinter haemorrhages a sign of?
Infective endocarditis
What does radial-radial delay indicate?
poor perfusion, perhaps to do with the aorta e.g. aortic stenosis or regurgitation
What does a collapsing pulse indicate?
Aortic regurgitation
What might tracking indicate?
infective endocarditis
What does facial pallor and sweating indicate?
myocardial infarction
What does facial malar flush indicate?
mitral stenosis
What does Xanthelasma and corne alarcus indicate?
High cholesteral - PAD or CAD
What does angular stomatitis indicate?
iron deficiency anaemia.
What does a JVP less than 4cm imply?
Right atrial pressure is less than 9cm of water
What does an elevated JVP imply?
Fluid overload of the right atrium and right heart failure
extreme election can also be due to mechanical obstruction of the SVC
What does a shift in apex beat suggest?
cardiomegaly - enlarged heart.
What does a ventricular heave suggest?
Right ventricular hypertrophy
What would thrills indicate?
an abnormal valve or septal defect
