Clinical Exam Flashcards
What scars are important to look out for in cardiac exam? And why are they important?
- Midline sternotomy scar: CABG, prosthetic valve
2. Thoracotomy scar: MVR, congenital heart disease
What are the different types of pulses? What do they mean?
Collapsing pulse - AR
What are signs of aortic stenosis?
Systolic ejection murmur best heard at aortic area, radiating to the carotids
What are signs of mitral regurgitation?
diffuse apex beat that’s not sustained
blowing pan-systolic murmur best heard at apex, radiating to axilla
What are signs of tricuspid regurg?
pan-systolic murmur best heard at left lower sternal edge, prominent c-v waves of JVP, pulsatile liver
How to differentiate VSD from tricuspid regurg?
VSD and tricuspid regurg both cause pan-systolic murmur best heard at LL sternal edge
But the murmur caused by VSD doesn’t radiate
And JVP abnormal with tricuspid
What are signs of aortic regurg?
Collapsing pulse, diastolic murmur best heard over LL edge, accentuated in expiration
If there is radio-femoral delay, and a systolic murmur heart at left upper sternal edge, what should you do next? What condition causes this?
Listen for a murmur at the interscapular region
Most likely coarctation of aorta
How to report back a murmur and cardiac exam?
_ murmur best heard at _, radiates to _.
Grade _, associated/not with systolic thrill
Heart sounds - S1, S2, extra
Apex beat is _ and displaced, located at _ IC in the _ line
Complications e.g. pulmonary HTN as evidenced by (sign). no sign of (complication)
Peripheral exam - pulse character, rate, anticoagulation bruises, IE stigmata
BP, temp. chart
Summary - murmur, severity, complication, no complication of, DDx
What to describe about AF?
irregularly irregular pulse
rate controlled at _bpm?
AF > anticoagulation > bruising?
DDx for mitral regurg?
- MVP
- IHD
- RHD
What happens if you can’t palpate the apex beat on the left side? What is this condition called?
Try right side
Maybe dextrocardia
