Cardiovascular examination signs Flashcards
Clinical signs
- cyanosis
- SOB
- pallor
- malar flush
- oedema
objects and equipment
- medical equipment
- mobility aids
- pillows
- vital signs
- fluid balance
- presciptions
Hands
- colour
- tar staining
- xanthomata
- arachnodactyly (‘spider fingers’) - sign of marfans
Signs in the hands associated with endocarditis?
- splinter haemorrhages
- janeway lesions
- osler’s nodes
What do cool hands suggest?
poor peripheral perfusion (e.g. congestive heart failure, ACS)
What do cool and sweaty/clammy hands suggest?
ACS
What does a cap refill time of greater than 2 suggest?
poor peripheral perfusion e.g. hypovolaemia, congestive heart failure.
* Need to assess central cap refill time
What are the causes of radio-radial delay?
- subclavian artery stenosis (e.g. compression by cervical rib)
- aortic dissection
- aortic coarctation
Causes of a collapsing pulse?
- normal physiological states (e.g. fever, pregnancy
- cardiac lesions (e.g. aortic regurg, patent ductus arteriosus)
- high output states (e.g. anaemia, arteriovenous fistula, thyrotoxicosis)
What is a slow rising pulse associated with?
aortic stenosis
What is a bounding pulse associated with?
aortic regurg as well as CO2 retention
What is a thready pulse associated with?
intravascular hypovolaemia in conditions such as sepsis
What does a raised JVP indicate?
Venous hypertension.
Cardiac causes of a raised JVP include?
- right-sided heart failure: commonly caused by left-sided heart failure. Pulmonary hypertension is another cause of right-sided heart failure, often occurring due to chronic obstructive pulmonary disease or interstitial lung disease.
- tricuspid regurgitation: causes include infective endocarditis and rheumatic heart disease.
- constrictive pericarditis: often idiopathic, but rheumatoid arthritis and tuberculosis are also possible underlying causes.
What does a positive hepatojugular reflux result suggest?
Right ventricle is unable to accommodate an increased venous return.
Conditions that frequently produce a positive hepatojugular reflux test include
- constrictive pericarditis
- right ventricular failure
- left ventricular failure
- restrictive cardiomyopathy
Eyes
- conjunctival pallor
- corneal arcus
- xanthelasma
- kayser-fleischer rings
Mouth
- central cyanosis
- angular stomatitis
- high arched palate
- dental hygiene
Displacement of apex beat suggests what?
Ventricular hypertrophy
Parasternal heaves are typically associated with
Right ventricular hypertrophy
What is a thrill?
A palpable vibration caused by turbulent blood flow through a heart valve (a thrill is a palpable murmur)
Aortic stenosis murmur
Ejection systolic murmur
Aortic regurgitation murmur
Early diastolic murmur
Mitral regurgitation murmur
Pansystolic murmur - auscultation into the axilla to identify radiation of this murmur
