Cardiovascular Assessment

Question 1

What does a clammy or sweaty patient suggest in a cardiovascular exam?

Answer 1

Potential shock or myocardial infarction.

Question 2

What does the Levine sign indicate?

Answer 2

Chest pain; patient clutching chest is a classic sign of myocardial infarction.

Question 3

What might pale or grey skin tone indicate?

Answer 3

Poor perfusion or cardiogenic shock.

Question 4

Why assess environmental factors during cardiovascular assessment?

Answer 4

Clues like medication, drugs, alcohol, temperature, or odours can influence cardiovascular status.

Question 5

What does capillary refill time assess?

Answer 5

Peripheral perfusion – delayed CRT suggests poor cardiac output.

Question 6

What does cyanosis in the hands indicate?

Answer 6

Hypoxaemia due to poor cardiac or respiratory function.

Question 7

What cardiovascular conditions can cause finger clubbing?

Answer 7

Endocarditis, heart failure, cardiomyopathy.

Question 8

What are Janeway lesions and what do they suggest?

Answer 8

Non-tender haemorrhagic lesions on palms/soles; indicative of infective endocarditis.

Question 9

What are Osler nodes?

Answer 9

Tender, raised red-purple nodules on fingers/toes – sign of infective endocarditis.

Question 10

What are splinter haemorrhages and what can cause them?

Answer 10

Small lines of bleeding under nails; trauma or infective endocarditis.

Question 11

What should be assessed with the radial pulse

Answer 11

Rate, rhythm, and volume.

Question 12

What BP targets apply for <80 and >80-year-old patients?

Answer 12

<80: aim <140/90 mmHg; >80: aim <150/90 mmHg.

Question 13

What does a narrow pulse pressure indicate?

Answer 13

CHF, aortic stenosis, or cardiogenic shock.

Question 14

What causes a wide pulse pressure?

Answer 14

Aortic regurgitation, hypertension, atherosclerosis.

Question 15

What is a significant bilateral BP difference?

Answer 15

> 20 mmHg systolic or >10 mmHg diastolic – could indicate aortic dissection.

Question 16

What causes postural hypotension?

Answer 16

Hypovolaemia, drug effects, or autonomic dysfunction.

Question 17

What is xanthelasma and what does it suggest?

Answer 17

Cholesterol deposits near the eyelids – indicates dyslipidaemia.

Question 18

What does corneal arcus indicate?

Answer 18

High cholesterol.

Question 19

What does conjunctival pallor suggest?

Answer 19

Anaemia.

Question 20

What is mallar flush and what condition is it linked to?

Answer 20

Facial redness associated with mitral stenosis or CO₂ retention.

Question 21

Why assess dental hygiene in a cardiovascular exam?

Answer 21

Poor hygiene can lead to infective endocarditis.

Question 22

What does a carotid bruit indicate?

Answer 22

Significant carotid atherosclerosis.

Question 23

What might scars in the left upper chest indicate?

Answer 23

Pacemaker or defibrillator placement.

Question 24

What does an axillary scar suggest?

Answer 24

Previous chest drains.

Question 25

What does a midline chest scar suggest?

Answer 25

Coronary artery bypass graft (CABG) surgery.

Question 26

What is the normal location of the apex beat?

Answer 26

5th intercostal space, midclavicular line.

Question 27

What does a displaced apex beat suggest?

Answer 27

Ventricular enlargement, heart failure, or cardiomyopathy.

Question 28

What are thrills in cardiovascular assessment?

Answer 28

Palpable murmurs – feel like vibrations under the hand.

Question 29

What might fluid at the lung bases suggest in a cardiac patient?

Answer 29

Heart failure or pulmonary oedema.

Question 30

Where is the aortic valve auscultated?

Answer 30

2nd intercostal space, right sternal border

Question 31

Where is the pulmonary valve auscultated?

Answer 31

2nd intercostal space, left sternal border.

Question 32

Where is the tricuspid valve auscultated?

Answer 32

4th intercostal space, lower left sternal border.

Question 33

Where is the mitral valve auscultated?

Answer 33

5th intercostal space, midclavicular line.

Question 34

What could a pulsatile abdominal mass indicate?

Answer 34

Abdominal Aortic Aneurysm (AAA).

Question 35

What is ascites and what cardiac condition can cause it?

Answer 35

Fluid in the peritoneal cavity; caused by right heart failure.

Question 36

What does peripheral oedema suggest?

Answer 36

Right-sided heart failure or fluid overload.

Question 37

What signs indicate limb ischaemia?

Answer 37

Pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia

Question 38

What are signs of deep vein thrombosis (DVT)?

Answer 38

Calf swelling, redness, warmth, tenderness