CVS Examination Qs Flashcards
What signs are we looking out for at first glance?
- SoB (Pericarditis/Pneumonia/PE)
- Cyanosis (R-L Shunting)
- Pallor (Haemorrhaging)
- Malar Flush (Cheeks due to MS)
- Oedema (CHF)
What are we looking for in the hands?
- Colour
- Cyanosis: Hypoxemia
- Pallor: Poor Peripheral Perfusion - Clubbing
- Infective Endocarditis
- Congenital Cyanotic Heart Disease - Hands
- Yes
What are we looking for in the Hands?
- Splinter Haemorrhaging
- Psoriatic Nail Disease
- Infective Endocarditis
- Sepsis - Janeway Lesions
- Non-tender Haemorrhagic Lesions
- Infective Endocarditis - Osler’s Nodes
- Red-purple tender lumps
- Infective Endocarditis
What else do we do for the hands?
- Check Temperature
- Cold: ACS, Congestive Cardiac Failure - Capillary Refill
- 2+: Poor Peripheral Perfusion
What causes Poor Peripheral Perfusion?
- Hypovolemia
2. Congestive Heart Failure
What is the Radio-Radial Delay?
Feel both wrists at the same time
- Coarctation of the Aorta
- Subclavian Artery Stenosis (Cervical Rib)
- Aortic Dissection
What is Collapsing Pulse?
- Aortic Regurgitation (Diastolic)
- Ask if there is pain in the shoulder
- Place a hand on the wrist and raise Right Arm Briskly
What can be seen in Brachial Pulse?
- Bounding: CO2 Retention
- Thready: Sepsis
- Slow: Aortic Stenosis
When auscultating Carotid Pulse, what are we looking for?
Bruits: Carotid Stenosis
Also to check for Cardiac Murmurs (Aortic Stenosis)
How do we check for JVP?
Turn their head to the left
Measure the IJV
Why do we not check EJV?
It branches at a right angle and less reliable for Central Venous Pressure
3cm between Sternal Angle and Top of IJV pulsation point with a ruler
What does Raised JVP mean?
- Venous Hypertension
2. Right Heart Failiure (Caused by Left)
What is the Hepatojugular Reflex?
- Putting pressure on the liver and looking for a rise in the JVP
When do we need to use HJR?
- RVF
- LVF
- Constrictive Pericarditis
- Restrictive Cardiomyopathy
What are we looking for in the face?
- Hyperlipidemia
- Conjunctival Pallor
- Corneal Arcus
- Xanthelasma
- Kayser-Fleischer Rings
What are we looking for in the mouth?
- Central Cyanosis
- Angular stomatitis (Iron deficiency)
- High arched Plate (Marfan Syndrome)
- Dental Hygiene (Infective Endocarditis)
What are we looking for in the chest?
Central: (Sternotomy/Thoracotomy)
Clavicular: Pacemaker
Left Mid-Axillary Line: SC ICD
Lateral Thoracotomy: Lift both arms
Where do we feel the apex beat?
5th Intercostla Space at Mid-clavicular Line
What is a Heave and why do we get it?
Palpated Precordial Impulse
Palm to Check
Right Ventricular Hypertrophy
What is a Thrill?
Palpable Vibration by Turbulent Blood Flow
Check all Four Valves
Where do we check the Mitral valve?
5th Intercostal Space in Midclavicular line
Where do we check the Tricuspid valve?
5th Intercostal Space on Left Sternal Edge
Where do we check the Pulmonary valve?
2nd IC space on the Left Sternal Edge
Where do we check the Aortic valve?
2nd IC space on the Right Sternal Edge
