Cardiovascular

Wash Hands Introduce Patients Name Explain Procedure Consent Expose Chest Position 45 -ricuspid ,egion )itral ,egion Axilla -urn patient onto left side )itral region it Patient *or0ard Hold Expiration Aortic ,egion Carotid Bruits

Inspect
Patient Comfort Breathing Appearance urrounding !e"g" #$% putum Pots& cars 'eformities Central C(anosis )alar *lush

Back
Percuss 1ungs Auscultate 1ungs 8 Pulm" #edema Inspect for acral #edema

Peripheries
)edial )alleolus for Peripheral #edema

Hands
Nailfold Infarction plinter Haemorrhages Clu++ing Capillar( ,efill -ime #slar.s Nodes /ane0a( 1esions Palmar Er(thema Palmar 2anthomata Peripheral -emp -ar taining Peripheral C(anosis

Extras
'ipstic9 :rine *undoscop( Peripheral Pulses BP

Closing
-han9 Patient Wash Hands

Overall
: B )

Pulses
Comment on: ,ate% ,h(thm% Character ,adial Collapsing Pulse ,adial3,adial 'ela( Brachial Carotid

Head and Neck

/4P Con5ucti6al Pallor Corneal Arcus 2anthalasmas 1ips7-ongue Central C(anosis

Chest
Palpate Apex Beat Identif( Apex location Hea6es -hrills

Auscultate
Aortic ,egion Pulmonar( ,egion

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Cardiovascular
What is indicated +( malar flush= SLE What is indicated +( splinter haemorrhages and nailfold infarcts= Infective endocarditis What is indicated +( #slars Nodes and /ane0a( 1esions and 0hat 0ould the( loo9 li9e= Infective endocarditis Oslars nodes raised palmar erythematous nodules Janeway lesions patches of erythematous rash What is indicated +( palmar er(thema= Polycythemia CO2 retention What is indicated +( palmar xanthomata= Elevated lipid levels In 0hat condition 0ould (ou find a collapsing pulse= Aortic Re ur itation When 0ould (ou expect radial3 radial dela(= Occlusion of atheroscleretic pla!ue"aneurysm Su#clavian artery stenosis What is the cause of radio femoral dela(= Coarctation of the aorta Ho0 0ould coarctation of the aorta present in teenagers7adults= $ypertension What is pulsus alternans= %eat to #eat volume chan e late heart failure What is pulsus paradoxus= Increased pulse volume on e&piration normal or due to air'ay constriction"cardiac tamponade What causes a raised /4P= $eart failure PE Pericardial effusion S(C o#struction What causes a sterna hea6e= Left ventricular hypertrophy What causes is a thrill= Palpa#le murmur

)ichael mith $;<;