This document outlines the steps for a cardiovascular assessment. It discusses obtaining the patient's history and demographic information, assessing vital signs, examining the skin, eyes, neck, chest, abdomen, and extremities, and performing tests like Allen's test and Homan's sign. Key parts of the exam include inspection, palpation, auscultation of heart sounds, assessing JVP, and evaluating pulses and edema. The goal is to thoroughly evaluate the cardiovascular system through medical history and physical exam findings.

1. Cardiac assessment

2. Introduction
•Assessment of the cardiovascular system is
one of the most important areas of the nurse’s
daily patient assessment. This video is designed
to be used with the guidelines already in effect
at your institution.

3. Important aspects
● Power of observation.
● Be as objective as possible.Assess with every tool possible; inspection,
palpation, etc.
● Report your findings as clearly as possible.
● Clear Charting

4. Articles Needed
A Clean tray containing
Wrist watch and pen
Stethoscope
Sphygmomanometer
Ruler and inch tape
Pen and paper

5. Anatomy of the
heart

6. Physiology of the heart
Cardiac cycle: Systole and diastole
Cardiac output- Amount of blood pumped by the left ventricle per minute
Stroke volume- Amount of blood pumped by the ventricle per beat
Preload - Volume of blood left in the ventricle at the end of DIastole
Afterload- SVR,Amount of resistance of the ventricles to open the aortic valve

7. Cardiovascular
assessment

8. Steps
Biographical data/Demographic data
History:
★ Current health history
★ Past medical history
★ Family history
★ Personal history
★ Risk factor analysis

9. General appearance
Look at the client and observe for
● Does the client lie quietly or restless
● Can the client lie flat or in upright position
● Do facial expression reflects pain or distress
● Are their signs of pallor or cyanosis

10. Basic information
Along with general appearance some baseline informations like
Body built
Consciousness
Orientation: To time/Place and Person
Body posture
Height/Weight and /BMI
Should be collected

11. Vital signs
Blood pressure: Both hands/Standing/Sitting/Lying
Pulse pressure: Systolic- diastolic (Normal 30-40mmhg)
Pp increases with Anxiety, Exercise,Bradycardia, Hypertension, Fever,CAD etc
Decreases with Shock,Heart failure, Hypovolemia,Mitral Regurgitation etc…
Mean arterial pressure: (MAP) ( 2xDiastolic BP) + systolic BP
3

12. Pulse points
Pulse should be checked for its Rate,Rhythm and Quality.
● Carotid
● Radial
● Brachial
● Femoral
● Popliteal
● Posterior tibial
● Dorsalis pedis

13. Common signs and symptoms of
cardiovascular disease
● Chest pain/ Discomfort
● Palpitations
● Syncope
● Fatigue
● Dyspnea
● Cough
● Weight gain
● Edema

14. Skin /Nail
● Color
● Texture
● Warmth
● Turgor
● Clubbing of finger
● Cyanosis
● Splinter hemorrhage

15. Capillary refill
● Capillary refill -
greater than 3
seconds in case of
Dehydration,PVD,Hy
pothermia and Shock

16. Clubbing of finger

17. Eyes
● Sclera/Conjunctiva - Signs of
anemia
● Xanthelasma : Yellowish plaques
around eye lids
● Arcus Senilis: Grey ring around iris

18. Neck
● Thyroid: For enlargement
● Carotid artery: Bruit
● Carotid pulse: Rate /Min
Pulse deficit:Difference between Apical pulse and Carotid pulse

19. JVP(Jugular Venous Pulsation)

21. Chest
Inspection: lesion/Scar/Mass/
Pacemaker
Palpation:
Precordial heaves: Visible or palpable pulsations/ Thrills
PMI (Point of maximum impulse) Apical pulse 5th intercostal

22. Chest - Auscultation

24. Normal and abnormal sounds
S1 - Closure of mitral and tricuspid valve- Best heard in Mitral area
S2 - Closure of pulonic and aortic valve- Best heard in Erb’s or Pulmonic area
MURMURS:Heard when there is turbulent blood flow within heart.
GALLOPS:
Pericardial Friction Rub : Caused by inflammation of pericardial sac

25. Abdomen
Abdominal aortic pulsation: present in case
of aneurysm
Bruits:
Hepatojugular reflux:
Positive indicates the inability of the right
heart to handle increased venous return

26. Extremities
Peripheral pulse and Peripheral edema

27. Allen’s test
Assessment of arterial blood flow in Radial and Ulnar artery

28. Homan’s sign

29. Summary ● Baseline data / History
● General appearance
● Vital signs
● Skin and Nail
● Eyes
● Neck/Carotid
● Chest
● JVP/HUX
● Abdomen
● Extremities
● Allen’s test
● Homan’s sign