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    Cardiovascular Examination: Preparation of The Patient

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    Lolla Sinwar
    The cardiovascular examination involves preparing the patient and inspecting, palpating, and auscultating the heart and vessels. The examiner evaluates the patient's appearance, vital signs, jugular venous pressure, peripheral pulses, precordial activity, and lung and abdominal exams to assess for abnormalities and murmurs that could indicate cardiovascular issues. A thorough exam following standardized steps is important for a comprehensive cardiac evaluation.

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    Cardiovascular Examination: Preparation of The Patient

    Uploaded by

    Lolla Sinwar
    117 views4 pages
    The cardiovascular examination involves preparing the patient and inspecting, palpating, and auscultating the heart and vessels. The examiner evaluates the patient's appearance, vital signs, jugular venous pressure, peripheral pulses, precordial activity, and lung and abdominal exams to assess for abnormalities and murmurs that could indicate cardiovascular issues. A thorough exam following standardized steps is important for a comprehensive cardiac evaluation.

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    Cardiovascular examination

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    The cardiovascular examination involves preparing the patient and inspecting, palpating, and auscultating the heart and vessels. The examiner evaluates the patient's appearance, vital signs, jugular venous pressure, peripheral pulses, precordial activity, and lung and abdominal exams to assess for abnormalities and murmurs that could indicate cardiovascular issues. A thorough exam following standardized steps is important for a comprehensive cardiac evaluation.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    117 views4 pages

    Cardiovascular Examination: Preparation of The Patient

    Uploaded by

    Lolla Sinwar
    The cardiovascular examination involves preparing the patient and inspecting, palpating, and auscultating the heart and vessels. The examiner evaluates the patient's appearance, vital signs, jugular venous pressure, peripheral pulses, precordial activity, and lung and abdominal exams to assess for abnormalities and murmurs that could indicate cardiovascular issues. A thorough exam following standardized steps is important for a comprehensive cardiac evaluation.

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    of 4

    Cardiovascular Examination

    PREPARATION OF THE PATIENT


    1. Greet the patient respectfully and with kindness.
    2. Introduce yourself
    3. Take a permission
    4. Insure privacy
    5. Wash your hands

     Exposure: to waist
     Position: 45 degree

    General examination (ABCDE)


    General inspection: from the END OF THE BED

    Comment on ABCDE:

    1. Appearance: looks well/ Unwell, Comfortable/ uncomfortable, Mental state: conscious, oriented to
    time, place & person
    2. Body built (cachectic, average, underweight, Overweight, obese) tall in Marfan
    3. Color (pallor, jaundice, pigmentation, malar flush in MS)
    4. Distress (dyspnic tachypnic)
    5. Environment (IV lines, drain, oxygen O2 mask, monitor, Defibrillator, pulse oximeter, ECG

    Take a vital signs of the patient ( HR, RR, BP, Temp)

    From the right side


    1. Hands: pallor creases in anemia, hot or cold, janeway, osler in IE Capillary Refill Time CRT
    2. Nails: clubbing, splinter hemorrhage in IE
    3. Arms: Tattoo, Needles marks.( IE)
    4. Pulse:
     Rate: if regular 15 s, If irregular 1 min
     Rhythm regular or not
     Volume: low or high or normal
     Character: if present eg. collapsing pulse, Pulsus alternans, slow-rising pulse
     check for RR delay in AD and RF delay in Aoric coarctation.
    5. Face: malar flush (MS)
     Eye: Jaundice, pallor, corneal arcus(lipid), Xanthelasma (lipid), petechial hemorrhage in IE
     Mouth: central cyanosis, ulcers, oral hygiene IE , high arched palate Marfan

    6. Neck:
    JVP Measurement.

    7. L.L for edema and scar for saphenous vein harvesting CABG

    Precordium exam
    INSPECTION:
     Look from both ends of the bed
    1. Symmetry of the chest
    2. Type of breathing: men abdominthoracic, women thoracoabdominal

     Look from RT side

    Comment upon:

    1. Deformity e.g pectus excavatum and carinatum.


    2. Scars and describe : name, site, length, old or new healed by1or 2 eg. Midsternotomy scar
    3. Visible apical pulsation
    4. Pacemaker, hair distribution, skin lesions, dilated veins

    PALPATION:

    Rules :
     Inform the patient what you are going to do
     Make sure that your hand is warm
     Ask the patient whether there is a painful area
     Maintain eye contact with palpation

    A. General PALPATION

    1. To Gain confidence
    2. Superficial Tenderness:
    B. Apex Beat

     Normally at 5th left ICS midclavicular line


     Impalpable in 30 %
     Shifted in case of (C O P D)

    C. Thrill :

     Palpable murmur, Grad more than 3


     Palpate same areas of auscultation ( areas of valves)

    D. Heave:

    Palpate left parasternal area in RVH

    AUSCULTAION:

     4 Areas
     Bell for low pitched sounds and diaphragm for high
     Auscultate 4 valves area
     Auscultate S1,S2 and if there S3 or S4 or rub or murmurs in each
    area
     Differentiate S1 from S2 by palpating carotid pulse: S1 comes
    before and S2 comes after carotid upstroke
     Ask patient to roll onto left side for MS

    If murmur present comment on : Site, Time, Grade, intensity,


    Radiation

     Areas for radiation of murmurs


     Carotid for AS
     Axilla for MR

     Auscultate 2nd Aortic Area (Erbs area)


    For AR in sitting position with hold breathing in expiration

    Keep the patient in sitting position and Auscultate lung bases and examine back for Sacral edema

    Say finally I should complete my examination by

     Peripheral vascular examination


     Fundoscopy
     Abdomen for ascites and liver congestion

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