Cardiovascular Signs

Question 1

Hypertension:

Answer 1

This is essentially a sign for fucking everything. Diagnosed first by doing ABPM

Question 2

Atherosclerosis:

Answer 2

• Tendon xanthoma
• Xanthelasmata
• Corneal arcus

Question 3

Stable Angina:

Answer 3

• Tar staining on the fingers
• Abdominal aortic aneurysm arterial bruits, absent or reduced peripheral pulses
• Xanthalasmata and corneal arcus
• Diabetic retinopathy (fundoscopy)
• Obesity
• Hypertension

Question 4

STEMI:

Answer 4

• Pallor
• Tachycardia
• Sweatiness
• Distress
• Atypical presentation is seen in women, the elderly diabetics due to reduced pain sensation. The classioc chest pain may not be present. Can present with:
• Dyspnoea
• Signs of Heart Failure
• Nausea/vomiting

Question 5

Mitral Stenosis:

Answer 5

• Malor flush on check (reduced cardiac output)
• Tapping apex beat
• Right ventricular heave
• Mid-diastolic murmur (heard best on expiration when patient is lying to the left)
• Opening snap on auscultation
• Low pulse volume (due to inadequete ventricular filling)

Question 6

Mitral Regurgitation:

Answer 6

• JVP is prominent if RHF is present
• Brisk displaced and hyperdynamic apex beat
• Right ventricular heave
• Pan-systolic murmur at the apex radiating to the left axilla
• Reduced S1, split S2, loud P2

Question 7

Aortic Stenosis:

Answer 7

• Slow rising pulse, low volume, narrow pulse pressure
• Vigorous sustained apex beat (heaving, non-displaced)
• Ejection systolic murmur, radiating to carotid artery
• Silent S2

Question 8

Aortic Regurgitation:

Answer 8

• Collapsing pulse, wide pulse pressure
• Faint peripheral pulses
• Displaced apex beat
• Early diastolic murmur (on left sternal edge)
• Soft S1 - Soft or absent S2

Question 9

Heart Failure:

Answer 9

• 3rd heart sound
• Displaced apex beat
• Tachycardia
• Oedema
• Raised JVP
• Chest crepitations or effusions

Question 10

Atrial fibrillation:

Answer 10

• Irregularly irregular pulse
• Variable intensity of S1

Signs of Left Ventricular Heart:

• Tachypnoea
• Tachycardia
• Raised JVP
• Noctrual cough productive of pink frothy sputum

Question 11

Acute limb ischaemia:

Answer 11

• Cold leg

-

Question 12

Chronic limb ischaemia:

Answer 12

• Ulceration
• Pallor
• Slow capillary refill time
• Cold leg
• Hair loss

Question 13

Abdominal aortic aneurysm:

Answer 13

• Painful pulsatile mass
• Hypotension
• Tachycardia
• Hypo-perfusion

Question 14

Thoracic aneurysm:

Answer 14

• Pulsatile mass
• Hypotension

Question 15

Infective Endocarditis:

Answer 15

• Splinter haemorrhages
• Pyrexia
• Splenomegaly
• Roth spots
• Osler nodes
• Janeway lesions
• New Murmur

Question 16

Aortic Dissection:

Answer 16

• Diastolic murmur
• Hypotension/Hypertension
• Reduced or absent peripheral pulses
• Difference in BP between right and left arm

Question 17

Restrictive Cardiomyopathy:

Answer 17

Features of right ventricular failure predominate: - Hepatomegaly

• Oedema
• Raised JVP
• Ascites

Question 18

Dilated Cardiomyopathy:

Answer 18

Signs of right heart failure present:

• Hepatomegaly
• Oedema
• Raised JVP
• Ascites (fluid build up)
• 3rd and 4th heart sound (present S3 and S4)
• Thready pulse
• Pleural effusion
• Pulmonary oedema
• Ankle oedema
• Sacral oedema
• Displaced apex beat

Question 19

Hypertrophic Cardiomyopathy:

Answer 19

• Ejection systolic murmur decreased by squatting
• Notched pulse pattern
• Irregular pulse if AF or ectopic beat
• Forceful apex beat with double impulse (if LV outflow tract is obstructed)
• Thrills and Murmurs
• JVP can be raised in very restrictive filling
• There can be no examination findings

Question 20

Myocarditis:

Answer 20

• S3 gallop
• Tachycardia
• Elevated JVP
• Rales

Question 21

Pericarditis:

Answer 21

• Pyrexia
• Myalgia
• Pericardial rub