Cardiovascular Findings

Question 1

Beau’s lines (transverse grooves in nails)

Answer 1

Recent serious disease

Question 2

Carotid bruit(whooshing sound)

Answer 2

Significantly narrowed artery

Question 3

Clubbing of fingers

Answer 3

Bacterial endocarditis and Fallot’s tetralogy

Question 4

Cyanosis-central (blue lips, fingers and toes)

Answer 4

Severe respiratory distress, Fallot’s tetralogy

Question 5

Cyanosis- peripheral (blue fingers and toes)

Answer 5

Cold temp, Raynaud’s disease

Question 6

Diagonal earlobe creases

Answer 6

Increase risk of a heart attack

Question 7

Dilated chest and arm veins

Answer 7

Superior vena cava obstruction

Question 8

Diastolic murmur in 2nd RICS

Answer 8

Aortic regurgitation

Question 9

Elevated jugular venous pressure

Answer 9

CHF, cardiac tamponade

Question 10

Diastolic murmur in 5th LICS

Answer 10

Mitral stenosis

Question 11

Displaced apex beat outside of 5th LICS

Answer 11

left ventricular hypertrophy

Question 12

Distended jugular veins

Answer 12

Congestive heart failure

Question 13

Erythema marginatum, cardiac murmur, joint pain

Answer 13

Rheumatic fever

Question 14

Hepatojugular reflex (increased JVP with RUQ pressure)

Answer 14

Congestive heart failure

Question 15

Koilonychia (spoon shaped nails)

Answer 15

Severe iron deficiency anemia

Question 16

Left parasternal heave

Answer 16

Right ventricular hypertrophy

Question 17

Loss of hair on the dorsum of the foot and toes

Answer 17

Peripheral vascular disease

Question 18

Malar flush

Answer 18

Mitral stenosis, carcinoid tumors

Question 19

Midsystolic click in 5th LICS

Answer 19

Mitral valve prolapse

Question 20

Pale nail beds, mucosa or tongue

Answer 20

Anemia

Question 21

Pansystolic murmur in 5th LICS

Answer 21

Mitral regurgitation

Question 22

Peripheral edema bilateral

Answer 22

CHF, chronic bronchitis, cirrhosis, renal failure

Question 23

Peripheral edema unilateral

Answer 23

Deep vein thrombosis, cellulitis

Question 24

Precordial thrill (palpable murmur)

Answer 24

Pathological murmur

Question 25

Pulsus alternans (strong beat followed by weak)

Answer 25

Left ventricular failure

Question 26

Pulsus bigeminus (double beats)

Answer 26

Hypertrophic obstructive cardiomyopathy

Question 27

Pulsus magnus (bounding pulse)

Answer 27

fever, anemia, hyperthyroidism

Question 28

Pulsus paradoxus (pulse decreases on inspiration)

Answer 28

> 10mm Hg: asthma, cardiac tamponade

Question 29

Pulsus parvus(low volume pulse)

Answer 29

shock, aortic stenosis

Question 30

Radio-femoral delay

Answer 30

Coarctation of the aorta

Question 31

Radio-radial delay

Answer 31

Subclavian steal syndrome

Question 32

S3 heart sound

Answer 32

Normal in healthy young adults. CHF

Question 33

S4 heart sound

Answer 33

Hypertension and cardiomyopathy

Question 34

Split 1st heart sound varies with breathing

Answer 34

Normal in healthy young 30 year old adults

Question 35

Split 1st heart sound fixed (no variation)

Answer 35

ASD or right bundle branch block

Question 36

Splinter hemorrhage (brown steaks on nails)

Answer 36

Subacute bacterial endocarditis

Question 37

Systolic murmur in 2nd RICS

Answer 37

Aortic stenosis

Question 38

Systolic murmur in the 5th LICS midclavicular line

Answer 38

Mitral regurgitation (incompetence)

Question 39

Titubation (nodding of the head with heart beat)

Answer 39

Aortic regurgitation (incompetence)

Question 40

Tracheal tug (downward pull on trachea)

Answer 40

Aneurysm of the arch of the aorta

Question 41

Xanthelasma (yellow eyelid deposits)

Answer 41

hyperlipidemai (in 50 % of patients)

Question 42

Water hammer pulse (bounding pulse)

Answer 42

Fever, anemia, hyperthyroidism

Question 43

Absence of Schamroth’s space or nail bed angle

Answer 43

Clubbing of fingers