Cardiac Exam Checklist

Download as doc, pdf, or txt
Download as doc, pdf, or txt
You are on page 1of 4

CARDIACEXAMINATIONCHECKLIST

20122013

Needto
Practice
Inspection(insittingposition)
1. Patientappearance(Comfortable,wellappearing,anxious,
shortofbreath,etc).
2. Noteanycyanosis,clubbing,pallor,cachexia,and
tachypnea(seeyourphysicaldiagnosistextfordefinition).
Vitalsigns,carotidpulses,jugularvenousfindings:
3. Checkradialpulsefor15seconds(Notepulserateinbeats
perminute,alsonoteifpulseisregularorirregular).
4. Determinebloodpressureineitherarm.Patientshouldbe
insittingpositionwithYOUsupportinghis/herarmatheart
level.Useappropriatesizedcuff,andlineupbrachialartery
withlineoncuff.Pumpcuffto200soyoudonotmiss
severesystolichypertension.(Warnpatientitmaybeabit
uncomfortable.)
5. Ideally,bloodpressureandpulseshouldbeassessedinboth
thesupineandsitting(orstanding)positionsinorderto
assessorthostaticchanges.Besuretoallowthepatient
threetofiveminutestoequilibratetothenewposition.
6. Positionpatientinsupineposition,withheadelevatedat30
45degrees.Standtothepatientsright.
7. Inspectrightcarotidartery:Turnpatientsheadtoleft,look
forboundingpulses.
8. Inspectrightinternaljugularveinwhilepalpatingright
radialartery.LookforAwavesandVwaves(seetext).
StatewhetherAwaveislarger,smaller,orthesameasthe
Vwave.(ThisisNOTaneasytask.Dontbefrustratedif
youcantseethewaves).
9. Sequentiallypalpateeachcarotidpulse.Arethepulses
equal?Assessvolumeandupstroke(bounding,diminished,
ordelayed).

Feel
Comfortable

CARDIACEXAMINATIONCHECKLIST
20122013
Needto
Practice
10. Sequentiallyauscultateeachcarotidarteryforbruitsor
transmittedmurmurs.

11. Statethejugularvenouspressureincentimetersofwater
(seetext).
12. Inspectprecordiumforabnormalpulsations.
Palpation
13. Palpatetheapicalimpulse,andnoteitslocation(e.g.5th
intercostalspace,midclavicularline).Noteiftheimpulseis
sharpordiffuse.
14. Palpatetheleftparasternalbordersforrightventricular
heavesorthrills(avibrationrepresentingaseveremurmur).
15. Palpatethe2ndleftintercostalspaceforpulmonaryartery
pulsations.
16. Palpatethesuprasternalnotchforaorticpulsations.
Auscultation(withheadofbedup3045degrees)
17. Listentothefollowingareasoftheprecordiumwithboth
thebellanddiaphragm:
2ndrightintercostalspace
2ndleftintercostalspace
Leftlowersternalborder
Apex
18. Listenfor:
S1andS2(Helpfulhint:Palpateacarotidpulsewhile
listening.S2isafterthecarotidpulse).

Feel
Comfortable

CARDIACEXAMINATIONCHECKLIST
20122013

CARDIACEXAMINATIONCHECKLIST
20122013

Needto
Practice
19. S3andS4(Thiscanbetricky.S4isbeforeS1andS2,andthe
threebeatssoundlikeTennessee.S3isafterS1andS2,
andthesoundismorelikeKentucky.)

20. Othersoundstolistenforduringsystoleanddiastole:
murmurs,rubs,clicks,openingsnaps(seeyourphysical
diagnosistextfordetaileddescriptions).
21. Askpatienttorollontoleftside.Identifytheapexby
palpation(i.e.,thepointofmaximalimpulseorPMI).
Usingthebell,listenattheapex.Thiswillbringoutmitral
valveabnormalities.

22. Askthepatienttositupandtoinhale,exhaledeeply,and
thenleanforward.Listenovertheaorticandpulmonic
areasforthediastolicmurmurofaorticinsufficiencyand
forpericardialrubs.(Thismaneuverisaparticularly
importantonetomasterandremember.)
PeripheralVascularExam
23. Inspectlowerextremitiesforsize,symmetry,color,
temperatureandvenouspatterns(e.g.venousstasis).
24. Palpatelowerextremitiesforsignsofedema.
25. Palpatelowerextremityarterialpulses(i.e.dorsalispedis
andposteriortibialarteries).

Feel
Comfortable

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy