Examination of Cardiovascular system

The Cardiovascular system (CVS) is composed of the heart and the blood vessels. The diseases involving cardiovascular system is a common cause of death in developed and developing countries.

Symptomatology

  • Dyspnoea (At rest or on exertion?, orthopnea?, PND?)
  • Precordial pain
  • Palpitation
  • Edema
  • Fatigue
  • Syncope
  • Haemoptysis

Examination

  • Pulse
  • Blood pressure
  • Jugular venous pulse (JVP)

Inspection

  • Shape of the chest (Skeletal deformities- kyphosis or scoliosis?)
  • Shape of precordium (Normal, Flattened, Bulging or Depressed?)
  • Apical impulse/thrust (Seen or not seen)
  • Other pulsations (Suprasternal, epigastric, left parasternal)
  • Engorged veins, scars, sinuses (Mention if present on the chest wall)

Palpation

  • Apex beat (Location, character)
  • Thrills
  • Palpable heart sounds
  • Palpable friction rub
  • Tracheal tug
  • Left parasternal heave
  • Other pulsations (Epigastric, suprasternal, pulsating liver)

Percussion

  • Upper margin of liver dullness
  • Left and right cardiac borders
  • Second left intercostal space

Auscultation

  • First and second heart sounds
  • Added sounds (third and fourth heart sounds)
  • Murmurs
  • Adventitious sounds (Gallop rhythm, pericardial knock, opening snap, ejection click)

Examination of other systems

  • Basal crepitations for pulmonary edema
  • Hepatomegaly, ascites, sacral andpedal edema for right heart failure
  • Splenomegaly
  • Neurological deficits (embolism)


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