Cardiac Physical Examination

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Slide 1 :

IN THE NAME OF GOD CARDIAC EXAMINATION BY: DR.M.Khabazian

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General examination: Pallor Central cyanosis:Po2<55,O2sat<75% Peripheral cyanosis Differential cyanosis Bronzing Petechiae Ecchymosis High-arched palate Non traumatic multiple fracture Arcus senile Mitral face's Clubbing Spider finger

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Janeway lesion osler node splinter hemorrhagic

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Barrel chest kyphosis straight back

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Hepatomegaly systolic pulsation on liver splenomegaly

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Abdominal aortic aneurysm

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Arterial bruit in abdomen

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JVP 0` 5.4cm 30` 8cm 45` 9.7cm 60` 9.8cm 90` 8cm

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Jugular Venous waveform a wave x decent c wave v wave y decent

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Kussmal sign: CP PTE

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Jugular vein: two peaks for every cardiac cycle(biphasic) falls in inspiration not palpable(except TR) obliterated with gentle pressure

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Carotid artery: single brisk upstroke (monophasic) no respiratory change to contour palpable cannot be obliterated

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Measuring the blood pressure More than 10 mmhg differential Hill sighn White coat HTN Masked HTN Orthostatic hypotension Pseudo HTN Wide pulse pressure

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AI CHILD

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Assessing the pulses

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Inspection and palpation of the heart trill Left para sternal heave Epigastric impulse Sustained apex beat Lateral retraction

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Heart sounds S1 Increase intensity Softer S2 Physiologic splitting Fix splitting Reverse splitting

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Systolic sounds ejection systolic AS PS non ejection MVP click

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Diastolic sounds Pericardial knock Opening snap Tumor plop S3 S4

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Cardiac murmurs Systolic murmur: Early/acute MR,TR,VSD Mid/AS,PS Late/MVP,TVP Diastoli murmur: Early/AI,PI Mid/MS,TS

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Machinery murmur PDA Coronary AV fistula Cervical venous hum Mamary soufle of pregnancy Small ASD+MS

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Thank you

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