Cardiovascular Exam Flashcards
What is important to look for on a general inspection of CVS exam?
Is patient unwell, breathless, cyanosis, oxygen mask, drip, body habitus
What is important to look for in an inspection of the hands?
Tar staining, finger clubbing, splinter haemorrhages, cyanosis, anaemia
What is important to look for in an inspection of the face?
Colour, malor flush (MS), eyes (anaemia), corneal arcus, xanthelasma (hyperlipidaemia), central cyanosis
What is the radial pulse assessed for?
Rate, rhythm, character, volume radio-radial delay, collapsing pulse
What other pulses are important to check, and what else should be offered?
Brachial and carotid pulses, and offer to take BP
What procedures need to be performed in inspection?
Observing of JVP, which is increased in right sided heart failure, (in IJV) and checking for hepatojuguloreflex
What is involved in palpation during CVS exam?
Palpation for heaves (along left sternal edge), thrills (palpable murmur) and the apex beat
What is involved in auscultation during CVS exam?
Auscultation of all the heart valves whilst feeling the carotid pulp, as well as auscultating the carotid arteries, the left sternal edge and axilla for radiation of murmurs
How do you remember where the heart valves are located?
All (aortic) prostitutes (pulmonary) take (tricuspid) money (mitral) at 22:45 (intercostal spaces)
How do you finish a CVS exam?
Assessment of sacral and peripheral oedema, and auscultation of the lung bases as well as peripheral pulse exam
What can cause a forceful apex beat, and presence of a heave?
Right ventricular hypertrophy
What is a thrill and what does it feel like?
Palpable murmur caused by turbulent blood flow through a heart valve, feels like a gentle vibration against the hand
What murmur does asking the patient to roll onto their left exaggerate?
Mitral stenosis
What murmur does asking the patient to sit forward exaggerate?
Aortic regurgitation
What murmur radiates to carotid artery?
Aortic stenosis (or bruits?)
