Basic Examination of the Cardiovascular System

General Inspection

• Breathlessness
• Discomfort
• Pain

Hands

• Capillary refill
• Splinter haemorrhages
• Koilonychia
• Clubbing
• Tar staining
• Peripheral cyanosis
• Radial pulses - rate and rhythm
• Collapsing pulse

Blood Pressue

Face

• Conjunctivae - anaemia
• Central cyanosis
• Xanthalesmata
• Corneal arcus
• Malar flush
• Carotid pulse - character, volume
• JVP - Jugular Venous Pulse

Chest Inspection

• Shape
• Scars - Surgical, pacemaker
• Visible apex beat

Palpation

• Heaves/Thrills
• Apex beat

Auscultation

• 4 areas with both bell and diaphragm whilst palpating carotid pulse
• A - Aortic Valve
• P - Pulmonary Valve
• T - Tricuspid Valve
• M - Mitral Valve

• Carotid bruits?
• Lung bases - fluid, basal crackles
• Feel for sacral oedema
  

• Accentuate murmurs - LHS - mitral stenosis (with bell) Axilla - systolic murmur (with diaphragm) Lower L sternal edge - aortic regurgitation (with diaphragm)

Other areas

• Abdomen - hepatomegaly, renal/femoral bruits
• Lower limb pulses - femoral, popliteal, posterior tibial, dorsalis pedis
• BP
• Opthalmoscopy - hypertensive retinopathy
• Urine dipstix testing
• Obs charts - pulse, temp., urine output