Cardiovascular examination steps and summary

Question 1

What are the 13 steps of cardiovascular examination?

Answer 1

1. WIIPE (wash hands, identity, intro, position/pain, explanation)
2. Observation
3. Examine hands- nails, palms and fingers
4. Pulses- radial and brachial
5. Blood Pressure
6. Face- Eyes, mouth, tongue
7. Neck- Carotid pulse, JVP
8. Chest inspection
9. Chest palpation
10. Chest Auscultation
11. Peripheries
12. Check liver
13. Wash hands, thank patient

Question 2

Presenting cardiovascular case back -7 points

Answer 2

1. Today I performed a cardiovascular examination on____.
2. On inspection there were no signs of CD
3. The pulse was regular on palpation and HR was 60
4. On palpation they had an undisplaced apex.
5. There were no heaves/thrills on auscultation
6. This was a normal cardiovascular examination
7. To complete the examination I would like to____

Question 3

To complete the Cardiovascular examination I would like to____(4)

Answer 3

1. Complete a full peripheral vascular examination
2. Urinalysis (for hypertension- proteinuria, haematuria)
3. Fundoscopy (hypertension-papilloedema)
4. ECG (arrhythmias)

Question 4

5 potential Cardiac Diagnoses

Answer 4

MR (Pansystolic murmur best heard in the mitral area, radiating to the axilla. Heave. Displaced Apex Beat)

MS (heard in mitral area)

AR

AS -Ejection Systolic murmur best heard in the aortic area, ( Right 2nd intercostal space at border of sternum), radiating to the carotids. Slow-rising pulse, with a narrow pulse pressure (difference between systolic and diastolic pressures is small). Heave – but apex beat is not displaced

Heart Failure (Peripheral oedema – ankles +/- sacrum. Ascites. Elevated JVP [venous congestion]. Orthopnoea – breathlessness on lying flat. cough. wheeze