Cardiovascular Examination

Question 1

General Inspection

Answer 1

Treatments/adjuncts
GTN spray - angina
O2
medication
Comfortable
SOB
Malar flush - mitral stenosis
Scars - chest, legs (CABG)

Question 2

Hand inspection

Answer 2

Splinter haemorrhages - bacterial endocarditis
Clubbing - infective endocarditis, cyanotic congenital heart disease
colour - hypoxia
temperature - hypovolaemia
sweaty/clammy - ACS
laneway lesions - bacterial endocarditis
osier's nodes - infective endocarditis
tar staining - smoker
xanthomata - hypercholesteraemia

Question 3

Hand and arm palpation

Answer 3

Radial pulse
Radio-radial delay - aortic coarctation
collapsing pulse - aortic regurgitation
brachial pulse
blood pressure

Question 4

JVP

Answer 4

increased - fluid overload, RVF, tricuspid regurgitation

Question 5

Face inspection

Answer 5

conjunctival pallor
corneal arcus - hypercholesteraemia
xanthelasma - hypercholesteraemia
central cyanosis
angular stomatitis - iron deficiency
high arched palate - increased risk of aortic dissection/aneurysm
dental hygiene - infective endocarditis risk factor

Question 6

Chest inspection

Answer 6

scars - thoracotomy, sternotomy, clavicular, left mid-axillary line
chest wall deformities - pacts excavated/carinatum
visible pulsations - apex: hypetension, ventricular hypertrophy

Question 7

Chest palpation

Answer 7

Apex beat - cardiomegaly
Heaves
Thrills - palpable murmur

Question 8

Auscultation

Answer 8

Aortic (plus sit forward, end expiration)
Pulmonary
Tricuspid
Mitral (left lateral position, inspiration)
Lung bases

Question 9

Closure

Answer 9

Lung bases
Sacral oedema
Ankle oedema

Question 10

Further Investigations

Answer 10

Full peripheral vascular examination
ECG - arrhythmias, myocardial ischaemia
Dipstick urine - proteinuria/haematuria - hypertension
Bedside BM - diabetes
Fundoscopy - maligna hypertension, papilloedema