Cardiac Exam

Question 1

Cardinal Symptoms

Answer 1

1. Chest pain
2. SoB
3. Palpitations
4. Oedema
5. Claudication
6. Exercise tolerance
7. Collapse/ dizziness/ postural hypotension
8. Orthopnea/ PND

Question 2

Position and Exposure

Answer 2

45 degrees

Chest and arms

Question 3

General Inspection

Answer 3

Comfortable
Oxygen therapy
GTN spray

Question 4

General Examination

Answer 4

Hands and nails - peripheral cyanosis, tar staining, clubbing

Radial pulse - rate and rhythm, radio-radial delay, collapsing pulse

BP - “I will carry it out”

Carotid pulse - character and volume

Eyes - anaemia, jaundice, xanthelasmata

Face/ Mouth - central cyanosis, hydration, glossitis

Chest and Neck - JVP, hepato-jugular reflex

Question 5

Inspection

Answer 5

1. Scars
2. Pacemaker
3. Visible pulsation

Question 6

Palpation

Answer 6

1. Apex
2. Heaves
3. Thrills

Question 7

Auscultation

Answer 7

1. Mitral - 5th ICS (L)
2. Tricuspid - 4th ICS (L)
3. Pulmonary - 2nd ICS (L)
4. Aortic - 2nd ICS (R)
5. Carotid arteries - bruit

Question 8

Special manoeuvres

Answer 8

1. Mitral stenosis
2. Aortic regurgitation
3. Mitral regurgitation
4. Aortic stenosis

Question 9

Extras

Answer 9

1. Sacral/ Lower limb oedema
2. Percuss and auscultate lung bases
3. Hepatomegaly, AAA
4. Pulses - dorsalis pedis, posterior tibial, femoral
5. Cardiac monitor, ECG