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Learning Objectives. Learn how to do a Cardiology Examination. General Principles. Introduction General InspectionHand, Face, Neck, Close InspectionPalpationPercussion (less relevant)AuscultationEnd. Start. Wash HandsGreetingConsentExposure (Waist Upwards, and ankles)Position (45%). General Inspection.
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1. Cardiology Examination
2. Learning Objectives Learn how to do a Cardiology Examination
3. General Principles Introduction
Hand, Face, Neck,
Percussion (less relevant)
4. Start Wash Hands
Exposure (Waist Upwards, and ankles)
5. General Inspection Clues around the bedside
Cyanosis (bluish tinge)
6. Hands Temperature (warm or cool)
Cyanotic Congenital Heart
Tobacco staining, tendon xanthomata
7. Hands Signs of Infective Endocarditis:
Painful, fingers and toes
8. Pulse Rate, Rhythm, Radial-radial delay
Do you have any pain in your shoulder?
Sign of Aortic Regurgitation
9. Blood Pressure Ask to do this
Say you would do both arms
10. Face Inspect for mitral flush
11. Neck Carotid Pulse, Volume and Character, don’t do both at once.
Pt should be at 45o
Don’t confuse with the carotid pulse
No more than 4cm above the sternal angle
12. Close Inspection
13. Palpation Heaves’ and Thrills
Place hand flat on chest to left then right of sternum (warn patient)
Heave: Sustained, thrusting usually felt at left sternal edge (= right ventricular enlargement)
Thrill: Palpable murmur felt as a vibration beneath your hand
14. Palpation Apex Beat
(Lowermost lateral position)
Normally 5th intercostal space in mid-clavicular line.
16. Auscultating the heart
17. Auscultating the heart Palpate the pulse at the same time
At apex listen with diaphragm and bell in left lateral position.
Check for radiation to axilla
Check carotids with bell
Right sided murmur loudest in inspiration
Lean forward for aortic and pulmonary regions.
18. Heart Murmurs Rumbling mid-diastolic murmur =
Pansystolic murmur =
Ejection Systolic murmur =
Early Diastolic Murmur =
19. Heart Diagram
20. End Check for Sacral Oedema,
Auscultate lung bases,
Check for Ankle Oedema
21. To Complete Examination Examine the abdomen
Peripheral vascular examination
Examine retina by fundoscopy
22. Finally Thank patient and Wash Hand
23. Now your turn!