Cardiovascular system
Precordium, heart sounds and murmurs, jugular venous pulse, peripheral pulses and cardiovascular syndromes.
22 pages
Sign
- Abnormal pulses: paradoxus, alternans, parvus et tardus, boundingThe shape of the pulse, not just its rate, gives away heart problems: a pulse that weakens on…
- Heart sounds: S1, S2 and its splitting, S3 and S4The heart's two normal beats are its valves closing; extra sounds point to stiff or overloaded…
- Murmurs: timing, grade, location and radiationA murmur is the sound of turbulent blood flow; describing it well almost always tells which…
- Signs of deep vein thrombosis: Homans and the Wells scoreA swollen, warm, painful leg on one side may be a clot; a simple score helps decide whether to…
Syndrome
- Acute limb ischemia and chronic arterial insufficiencyA leg that suddenly turns cold, pale and pulseless is an emergency; pain on walking that stops…
- Cardiac tamponade: Beck triad and pulsus paradoxusFluid or blood under pressure in the sac around the heart stops it from filling; it is an…
- Chest pain: ischemic, pericardial, pleural and other patternsNot all chest pain comes from the heart, but the cardiac and life-threatening kinds must be…
- Heart failure syndrome: left- and right-sided signsWhen the heart cannot pump well, fluid builds up behind it: in the lungs if the left side fails…
- Hypertensive emergency: target-organ signsVery high blood pressure is an emergency when it is already harming the brain, eyes, heart…
- Shock: the clinical signs and the typesShock means the blood cannot deliver enough oxygen to the organs; it shows in the skin, the…
Maneuver
- Allen testBefore puncturing the artery at the wrist, check that the hand's other artery can supply it on…
- Dynamic auscultation: Valsalva, squatting, standing and handgripChanging the patient's posture or effort while listening alters murmurs and helps tell which one…
- Hepatojugular (abdominojugular) refluxPressing the abdomen gently and steadily and watching whether the neck vein rises and stays up…
- Varicose veins: the Trendelenburg (Brodie–Trendelenburg) testEmptying the veins with the leg raised, applying a tourniquet and watching how they fill on…
Exam technique
- Cardiac auscultation: the areas and the orderListening to the heart at four set places on the chest, always in the same order, so no sound or…
- Jugular venous pressure and the venous pulseThe height of the pulsation in the neck vein estimates the pressure inside the right heart, with…
- Peripheral pulses and the ankle–brachial indexFeeling the pulses in arms and legs and comparing ankle and arm blood pressure uncovers blocked…
- Precordial inspection and palpation: apex beat, heaves and thrillsLooking at and feeling the chest over the heart tells a lot: where the apex beats, whether a…
Topic
- Cardiac studies: stress test, Holter, echo, nuclear, EP study and cathThe main heart tests after the ECG: what each one shows, when it is chosen, how the patient is…
- Palpitations: what the patient feels, what to ask and the danger signsFeeling the heart race, pound or skip: the questions that separate harmless extra beats from a…
- The abnormal ECG: hypertrophy, conduction blocks and main arrhythmiasHow to recognise the most common abnormal ECG patterns: a thick heart wall, blocked wiring, and…
- Valve murmurs: the table to knowThe seven most-tested murmurs side by side in one table: when they sound, where, where they…
A to Z
Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis.
Representative model, for educational purposes only.