CV Flashcards
General Inspection
Bedside - GTN spray/O2/medication/mobility aids
Malar flush - mitral stenosis
Inspect chest - scars or visible palpitations
Inspect legs - scars from saphenous vein harvest for CABG/peripheral oedema/missing limbs
Hands palm down
Splinter haemorrhages - bacterial endocarditis
Finger clubbing - IE, cyanotic congenital heart disease
Hands palms up
Colour - hypoxia Temperature - cool may suggest poor cardiac output Sweaty - acute coronary syndrome Janeway lesions - bacterial endocarditis Osler's nodes - IE Tar staining Xanthomata Capillary refill time
Pulse
Radial pulse
Radio-radial delay - aortic coarctation
Collapsing pulse - aortic regurg
Brachial pulse - assess volume and character
BP - narrow is aortic stenosis, wide is aortic regurg
Carotid - assess character and volume , slow rising is aortic stenosis
JVP
Mention performing hepatojugular reflux
Raised JVP - fluid overload/right ventricular failure/tricuspid regurg
Eyes
Conjunctival pallor
Corneal arcus
Xanthelasma
Mouth
Central cyanosis
Angular stomatitis - iron def
High arched palate - Marfan syndrome (aortic aneurysm)
Dental hygiene - IE
Scars
Thoracotomy - valve surgery
Sternotomy - CABG
Calvicular - pacemaker
Left mid-axillary line - subcut implantable cardioveter defib
Chest wall - pectus excavatum
Visible pulsation - hypertension/ventricular hypertrophy
Palpitation
Apex beat
Heaves - right ventricular hypertrophy
Thrills - murmur
Auscultation
Palpate carotid for first heart sound Mitral Tricuspid Pulmonary Aortic Repeat with bell Accentuation manoeuvre Regurg
Lungs
Crackles - pulmonary oedema
Chronic lung disease
Sacral oedema - right ventricular failure
Further assessments
Full peripheral vascular exam Record 12 lead ECG Dipstick urine Bedside capillary blood glucose Fundoscopy
