CARDIOVASCULAR ASSESSMENT

INTRODUCTION

DEFINITION OF TERMS
 Myocardium- cardiac muscle tissue, is
responsible for keeping the heart pumping blood
around the body
 Arrhythmia is a problem with the rate or rhythm
of the heart can beat too fast, too slowly, or with
an irregular rhythm.
o Caused by changes to heart tissue. It can
also occur suddenly as a result of exertion
or stress, imbalances in the
blood, medicines, or problems with
electrical signals in the heart.
 When a heart beats too fast, the condition is
called tachycardia.
 When a heart beats too slowly, the condition is
called bradycardia.
 Ventricular fibrillation is an abnormal heart
rhythm in which the ventricles of the heart quiver
instead of pumping normally. It is due to
disorganized electrical activity.

CHOLESTEROL BLOOD FLOW SEQUENCE

  A waxy, fat-like substance that's found in all the
cells in your body.
 Cholesterol is actually part lipid, part protein.
 Body uses it to: build the structure of cell
membranes, Make hormones like oestrogen,
testosterone and adrenal hormones.
Help your metabolism work efficiently, for
example,  essential for your body to produce
vitamin D.
 The liver, other organs and other cells in your
body produce about 80 percent of
the cholesterol in the blood.
 20% of Cholesterol can also be found in animal
meat, fried and processed food.
 With high cholesterol, you can develop fatty
deposits in your blood vessels.
 Eventually, these deposits grow, making it
difficult for enough blood to flow
through your arteries. Sometimes, those
deposits can break suddenly and form a clot that
causes a heart attack or stroke.
Inferior/Superior Vena Cava > Right Atrium >
Tricuspid Valve > Right Ventricle > Pulmonary
Valve > Pulmonary Artery > Capillaries >
Pulmonary Vein > Left Atrium > Mitral > Left
Ventricle > Aortic Valve > Aorta > Throughout The
Body
TAKE NOTE: While it is convenient to describe the
flow of blood through the right side of the heart and
then through the left side, it is important to realize that
both atria and ventricles contract at the same time. The
heart works as two pumps, one on the right and one on
the left, working simultaneously.
COLLECTING SUBJECTIVE DATA
History of Present Health Concerns:
 “Do you experience chest pain? If yes, use
COLDSPA.
 “Does your heart ever beat faster? “Does your
heart skip beats?”

ANATOMY AND PHYSIOLOGY

Other Symptoms
 “Do you tire easily?”
 “Do you have difficulty breathing”? SOP
(Shortness Of Breath)?
  “Do you experience dizziness?” oxygen-rich blood. It may feel like pressure or
 “Do you wake up at night with an urgent need to squeezing pain, steady and severe in your
urinate?” chest. 
 “Do you experience swelling in your feet, ankles  Shortness Of Breath (SOP)
or legs?”
ASSESSEMENT ARTICLES
Personal Health History
 “Have you been diagnosed with a heart defect or
a murmur”?
 “Have you had heart surgery?”
 “Have you ever had an ECG?”
 “Have you ever had a blood test called lipid
profile?”
 Do you know your cholesterol level?”
 “Do you take medications or use other treatment COLLECTING OBJECTIVE DATA
for heart disease?”
INSPECTION
Family History
 “ Is there a history of HPN, MI, CAD, elevated EYES
cholesterol levels, DM in your family”?

Lifestyle And Health Practices

 “Do you smoke? How many packs of cigarettes
per day and how many years?”
 “What type of stress do you have in your life?”
 “How much alcohol do you consume?”
 “Do you exercise?” What type?”
 “Describe your daily activities”
CHEST
HISTORY

PAST HEALTH HISTORY SKIN

CURRENT LIFESTYLE AND PSYCHOSOCIAL

STATUS
 Nutrition
 Smoking
 Alcohol
 Exercise
 Drugs
 Family History
CYANOSIS
PAIN DESCRIPTIONS
 Using COLDSPA in identifying and
determining pain
 Characteristics: stabbing, cutting, stinging,
burning, boring, splitting, colicky, crushing,
gnawing, nagging, gripping, scalding, shooting,
or throbbing character
 ANGINA - chest pain or discomfort caused
when your heart muscle doesn't get enough
XANTHOMAS

EDEMA

CHEST PERCUSSION

PALPATION

AUSCULTATION
 The sound is heard most in the LEFT
VENTRICLE because it is where the blood is
distributed throughout the body.
 Lub – produced by the mitral & tricuspid
valves
 Dub – produced by the pulmonary & aortic
valves

Sound 1 (S1)

PULSE POINTS

Sound 2 (S2)
 EXTRA HEART SOUNDS

SOUND 3 (S3) SUMMATION GALLOPS

OPENING SNAP

Sound 4 (S4)

EJECTION CLICK

 It is normally heard in well trained athletes.

MIDSYSTOLIC CLICK

PERICARDIAL FRICTION RUB

MURMURS

TAKE NOTE: patient should be in a supine position

ASSESSMENT
NECK VESSELS
Inspection: Observe the jugular
venous pulse. The client should
be in a supine position.
Auscultate the carotid
arteries if the client is
middle-aged or you
suspect cardiovascular
disease. Place the bell of
the stet and ask the client
to hold his breath for a
moment.
Palpate the carotid
arteries. Place two
fingerpads to feel for the
HEART
Inspect for any
pulsations on
anterior chest over
heart.
Palpate the apical impulse -
When checking the pulse, the
pulse at the apical impulse (5th
ICS, Mid-Clavicular Line) must
be higher than the radial pulse
(wrist area).
Auscultate HR and rhythm
Auscultate for a pulse rate
deficit. Count for a full
minute
Auscultate to identify S1 and
S2.Auscultate the first heart
sound (S1 or lub) and the
second heart sound ( S2 or
dubb)
Listen to S1. Use the
diaphragm of the
stethoscope
NORMAL FINDINGS
The jugular pulse is not normally
visible with the client sitting upright.
No blowing or swishing sounds are
heard.
 Normally detects a smooth, fairly
rapid outward movement beginning
shortly after the first heart sound and
cardiac apical impulse.
The pulse peaks about one-third of
the way through systole.
Pulses are equally strong; a 2+
Apical pulse (point of maximal
impulse) may not be visible. If
apparent, it would be in the mitral
area(Left MCL, 4th or 5th ICS)
No abnormal pulsations or feels like a
gentle tap and is small in amplitude and
corresponds to first two thirds of
systole especially in thin clients
Normal heart rates at rest: Children
(ages 6 - 15) 70 – 100 beats per minute.
Adults (age 18 and over) 60 –
100 beats per minute.
The radial and apical should
be identical.
Apical can be higher than
Radial
A distinct sound is heard in each
area but loudest in the apex.
ABNORMAL FINDINGS
Fully distended jugular veins may
indicate increased CVP that may be a
result of right ventricular failure,
pulmonary HPN.
A bruit, which is a swoshing sound
is caused by turbulent blood flow, is
indicative of occlusive arterial
disease.
Pulsations which may be
called heaves or lifts are
considered abnormal.
Bradycardia- less than 60 bts/min.
Its abnormally low heart
rate can cause the brain and other
organs to become oxygen-deprived
Tachycardia –more than 100
bts/min. When your heart is beating
too fast, it may not pump enough
blood to the rest of your body which
starve your organs and tissues of
oxygen 
A great difference may indicate
atrial fibrillation, atrial flutter.
Listen to S2. Use the Distinct sound is heard in
diaphragm of the each area but is loudest at the
stethoscope base.
Auscultate for extra heart Usually no extra heart sounds are
sounds. heard.