The document summarizes key aspects of performing a bedside cardiovascular examination. It discusses examining a patient's history for common cardiovascular symptoms. It then outlines how to examine the arterial pulse, measure blood pressure, and examine jugular venous pulse waves and pressure. The document also provides details on inspecting the chest, palpating the precordium, auscultating heart sounds and murmurs, and performing dynamic auscultation with maneuvers.
This document provides an overview of the cardiovascular physical examination. It reviews important aspects of the exam including vital signs, observation, palpation, auscultation, and specific findings related to heart failure, ischemia, murmurs, extra heart sounds, jugular venous pressure, edema, and post-catheterization complications. The goal is to focus on key elements that clinicians will commonly encounter in clinical practice.
This document provides an overview of cardiovascular system examination. It discusses symptoms associated with cardiovascular issues and methods for physical examination including pulse examination, heart auscultation areas, and percussion of heart borders. Key examination techniques are outlined such as assessing pulse rate, rhythm, volume and character. Common pulse abnormalities like pulsus deficit and pulsus alternans are also defined.
Peripheral pulsations and blood pressure measurementabeerabdulkareem
This document describes how to assess peripheral pulses and measure blood pressure. It outlines the locations of major arteries where pulses can be felt, including the carotid, brachial, radial, femoral, popliteal, posterior tibial, and dorsalis pedis arteries. It provides steps for properly measuring blood pressure using a sphygmomanometer and stethoscope. This includes positioning the patient, wrapping the cuff, palpating pulses to estimate systolic pressure, auscultating Korotkoff sounds to determine systolic and diastolic pressures, and defining normal blood pressure ranges.
1) The arterial pulse is caused by the pressure wave generated from left ventricular contraction and ejection of blood into the aorta. This pressure wave travels faster than blood flow through the arteries.
2) The characteristics of a normal pulse include a rate of 60-100 bpm, regular rhythm, and features of the pressure wave such as the anacrotic limb, dicrotic notch, and peak pressure before aortic valve closure.
3) Various abnormalities in pulse rate, rhythm, volume, and wave characteristics provide clues to underlying cardiovascular conditions such as aortic stenosis, which causes delayed upstroke, anacrotic pulse, and reduced volume; or aortic regurgitation, seen as a coll
The medicos PDF app was used to collect this information. I stumbled discovered this amazing app when searching for various slides and books and decided to share it with you all. The Google Play Store has a free version of the app.
Importance for learners:
MBBS/Dental
Nursing
Pharmacy
Microbiology
BPH
MPH
MDS
MD
Ophthalmology
Paramedics
The document provides information on assessing the cardiovascular system. It includes objectives of the assessment, anatomy and physiology of the heart, conduction system, blood flow, heart sounds, ECG, and vascular system. It also outlines components of cardiovascular history taking using Gordon's functional health patterns and physical assessment techniques for inspection, palpation, percussion, and auscultation of the heart and peripheral vasculature.
This document provides information on assessing cardiovascular health. It begins with an introduction noting cardiovascular disease is a leading cause of death. It then outlines the objectives which are to review cardiovascular anatomy and physiology, describe physical assessment, and review diagnostic procedures. The document proceeds to describe cardiovascular anatomy including the heart, circulation, and valves. It provides details on performing a cardiovascular assessment including taking a history, inspection, palpation, auscultation, and measuring blood pressure.
This document provides an overview of the cardiovascular physical examination. It reviews important aspects of the exam including vital signs, observation, palpation, auscultation, and specific findings related to heart failure, ischemia, murmurs, extra heart sounds, jugular venous pressure, edema, and post-catheterization complications. The goal is to focus on key elements that clinicians will commonly encounter in clinical practice.
This document provides an overview of cardiovascular system examination. It discusses symptoms associated with cardiovascular issues and methods for physical examination including pulse examination, heart auscultation areas, and percussion of heart borders. Key examination techniques are outlined such as assessing pulse rate, rhythm, volume and character. Common pulse abnormalities like pulsus deficit and pulsus alternans are also defined.
Peripheral pulsations and blood pressure measurementabeerabdulkareem
This document describes how to assess peripheral pulses and measure blood pressure. It outlines the locations of major arteries where pulses can be felt, including the carotid, brachial, radial, femoral, popliteal, posterior tibial, and dorsalis pedis arteries. It provides steps for properly measuring blood pressure using a sphygmomanometer and stethoscope. This includes positioning the patient, wrapping the cuff, palpating pulses to estimate systolic pressure, auscultating Korotkoff sounds to determine systolic and diastolic pressures, and defining normal blood pressure ranges.
1) The arterial pulse is caused by the pressure wave generated from left ventricular contraction and ejection of blood into the aorta. This pressure wave travels faster than blood flow through the arteries.
2) The characteristics of a normal pulse include a rate of 60-100 bpm, regular rhythm, and features of the pressure wave such as the anacrotic limb, dicrotic notch, and peak pressure before aortic valve closure.
3) Various abnormalities in pulse rate, rhythm, volume, and wave characteristics provide clues to underlying cardiovascular conditions such as aortic stenosis, which causes delayed upstroke, anacrotic pulse, and reduced volume; or aortic regurgitation, seen as a coll
The medicos PDF app was used to collect this information. I stumbled discovered this amazing app when searching for various slides and books and decided to share it with you all. The Google Play Store has a free version of the app.
Importance for learners:
MBBS/Dental
Nursing
Pharmacy
Microbiology
BPH
MPH
MDS
MD
Ophthalmology
Paramedics
The document provides information on assessing the cardiovascular system. It includes objectives of the assessment, anatomy and physiology of the heart, conduction system, blood flow, heart sounds, ECG, and vascular system. It also outlines components of cardiovascular history taking using Gordon's functional health patterns and physical assessment techniques for inspection, palpation, percussion, and auscultation of the heart and peripheral vasculature.
This document provides information on assessing cardiovascular health. It begins with an introduction noting cardiovascular disease is a leading cause of death. It then outlines the objectives which are to review cardiovascular anatomy and physiology, describe physical assessment, and review diagnostic procedures. The document proceeds to describe cardiovascular anatomy including the heart, circulation, and valves. It provides details on performing a cardiovascular assessment including taking a history, inspection, palpation, auscultation, and measuring blood pressure.
The document discusses the cardiovascular examination. It covers examining the pulse, peripheral pulses, pallor, clubbing, cyanosis, and edema. It also discusses examining the jugular venous pressure (JVP), palpating the apex beat and conditions where it may not be found, percussion of the heart, and auscultating the heart sounds and murmurs. The document is intended as a guide for medical students on performing the cardiovascular exam.
This document provides details on cardiovascular examination including cardinal symptoms, chest pain characteristics, breathlessness causes, palpitations description, syncope causes, and edema types. It also describes techniques for cardiovascular auscultation including listening locations, sounds, murmur characteristics like timing, intensity location, loudness, quality, pitch, radiation, and changes with maneuvers.
Cardiac physical exam and innocent murmurs presentationrajasthan govt
The document discusses examination of the cardiovascular system by assessing arterial pulses. It defines arterial pulses and describes how to evaluate the rate, rhythm, volume, and character of pulses at different arterial sites. Specific pulse abnormalities are also outlined, such as pulsus paradoxus and dicrotic pulse. The summary evaluates arterial pulses to examine cardiovascular function.
This document provides guidance on performing a cardiovascular examination, including:
1. Examining the general appearance, vital signs, jugular venous pressure, peripheral edema, and hands of the patient.
2. Performing a local heart examination using the IPPA sequence of inspection, palpation, percussion, and auscultation of the four heart valve areas.
3. During auscultation, commenting on heart sounds, extra sounds like murmurs, and lung bases.
Cardiac physical exam and innocent murmurs presentation june 2020rajasthan govt
The document discusses examination of the cardiovascular system by assessing arterial pulses. It defines arterial pulses and describes how to evaluate the rate, rhythm, volume, and character of pulses at different arterial sites. Specific pulse abnormalities are also outlined, such as pulsus paradoxus and bisferiens pulse, which provide clues to underlying cardiovascular conditions like constrictive pericarditis or aortic stenosis. The summary evaluates arterial pulses to examine cardiovascular function.
1. The document describes the examination of a patient with signs of infective endocarditis including splinter hemorrhages, purpura, and Janeway lesions.
2. Finger clubbing is described in four stages from increased ballotability to thickening of the distal finger resembling a drumstick. Clubbing can be caused by various cardiac and respiratory conditions.
3. The examination of arterial pulses, jugular venous pulsation, carotid pulsation, apical impulse, heart sounds, murmurs and additional sounds are outlined.
This document provides information on cardiovascular examination, specifically examining the arterial pulse. It defines an arterial pulse as the pressure wave felt along peripheral arteries with each left ventricular contraction. Key points discussed include the rate, rhythm, volume, and character of the pulse. Specific pulse abnormalities are defined, such as pulsus paradoxus, dicrotic pulse, and pulsus alternans. Methods for examining different peripheral pulses like the radial, brachial, femoral, and carotid are outlined.
Clinical assessment of the cardiovascular system. Featured: Main symptoms and physical exam. References from Bates' guide to physical examination and history taking and Medex app.
This document provides an overview of how to examine the cardiovascular system through history, examination of vital signs, inspection, palpation, and auscultation. It details how to examine the pulse, blood pressure, jugular venous pulse, apex beat, and heart sounds. It describes normal findings as well as abnormalities that may be found and how to characterize different types of murmurs. The examination is supported by additional tests like ECG, chest x-ray, and echocardiogram.
This document provides an overview of various diagnostic tools used in cardiology, including electrocardiography (ECG), non-invasive cardiac imaging modalities like echocardiography and nuclear imaging, and invasive diagnostic procedures like cardiac catheterization and coronary angiography. It describes the basic principles, clinical applications, and abnormalities detected by each diagnostic modality.
Brief Presentation on clinical examination of Cardio Vascular System with Report of Normal case
references:
macleod's clinical examination 13th edition
hutchinson clinical methods
This document provides information on examining the cardiovascular system. It discusses the anatomy of the heart and describes how to examine jugular venous pressure. A normal jugular venous pressure is less than 8 cm above the right atrium. The document outlines the steps to measure jugular venous pressure including inspecting the internal jugular vein and measuring the highest point of pulsation in relation to the sternal angle. Elevated jugular venous pressure indicates abnormal cardiac function or pressures in the right heart.
The document provides guidance on performing a cardiovascular examination, including taking a history, inspecting the precordium, palpating the chest, and auscultating heart sounds. It details the specific areas to examine by palpation and auscultation, and what abnormalities in findings may indicate different cardiovascular conditions. The examination techniques are described step-by-step, emphasizing the importance of patient comfort and obtaining accurate information.
This document provides an overview of cardiac anatomy, physiology, and assessment. It begins with a description of the heart's structure including the coronary arteries and conduction system. Key concepts are explained such as the cardiac cycle, output, and factors that determine stroke volume like preload, afterload, and contractility. Common symptoms of cardiovascular disease are outlined. The document then details the steps and focus of a cardiac assessment including gathering a health history and examining vital signs, skin, neck, heart, lungs, and abdomen. Potential exam findings and complications are also noted.
Clinical examination of Radial pulse by Pandian M, Tutor, Dept of Physiology,...Pandian M
Introduction
Ideal graph which represented radial pulse
Importance
Method of examination
Procedure
The following aspects (parameters) of the pulse are studied
Precautions:-
Discussion
Applied aspects
Other peripheral pulses
This document provides an overview of cardiovascular system assessment for nursing students. It begins by outlining the learning objectives which are to review cardiovascular anatomy and physiology, learn how to take a cardiac health history and perform a physical exam, and understand diagnostic tests. The document then describes the anatomy of the heart and vessels, heart sounds, heart rate, peripheral vascular assessment, cardiac function assessment including history taking and physical exam, and various diagnostic tests including ECG, echocardiogram, stress test, and hemodynamic monitoring.
Examination of cardiovascular system in PediatricsBirhanu Melese
The paediatrics cardiovascular exam can be a logistical minefield, requiring a good understanding of cardiac anatomy and possible congenital anomalies. With babies especially, it’s important to be opportunistic with your examination – doing the three ‘quiet things’ first: auscultation of heart sounds, auscultation of breath sounds and palpation of femoral pulses.
This document provides information on assessing the cardiovascular system. It begins with an introduction on the importance of cardiovascular assessment by nurses. It then covers anatomy and physiology of the heart, including the valves and blood circulation. Physical examination techniques are outlined, including inspection, palpation, percussion and auscultation. Common abnormalities that may be found on assessment are listed. Finally, additional investigation methods are mentioned, such as electrocardiograms, blood tests and cardiac imaging.
This is presentation of basics of Electrocardiography and its fundamentals specially for beginners of medical professions. The content is intended keeping first year medical professionals as center point.
DIFFERENT PULSE SITES (pulse -introduction & images)martinshaji
The document discusses different pulse sites in the body. It defines a pulse as the wave of blood in the artery created by the contraction of the left ventricle during each cardiac cycle. There are peripheral pulses that can be felt over bony prominences like the carotid, radial, and popliteal arteries, and apical pulses that are monitored with a stethoscope over the heart apex. Key parameters of pulses include rate (bradycardia is under 60 beats/minute, tachycardia is over 100), and rhythm or time interval between beats. Common pulse sites that can be checked include the temporal, carotid, brachial, radial, femoral, popliteal, and dorsalis pedis arteries.
This document presents a case of multivalvular heart disease involving the mitral, aortic, and tricuspid valves. On examination, the patient had signs of mitral and aortic stenosis as well as aortic and tricuspid regurgitation. The clinical diagnosis was severe mitral restenosis, severe aortic stenosis, moderate aortic regurgitation, and functional tricuspid regurgitation, likely due to rheumatic heart disease. The document then discusses various topics related to multivalvular heart disease including common causes, factors modifying presentation, features of individual valve lesions, and combinations of lesions.
MULTI VALVULAR HEART DISEASE clinical presentation Kurian Joseph
This document presents a case of multivalvular heart disease involving the mitral, aortic, and tricuspid valves. On examination, the patient had signs of mitral stenosis, aortic stenosis, moderate aortic regurgitation, and functional tricuspid regurgitation. The clinical diagnosis was severe mitral restenosis, severe aortic stenosis, and complications of pulmonary hypertension. Common causes, clinical presentations, and assessments of various combinations of multivalvular diseases are then discussed.
The document discusses the cardiovascular examination. It covers examining the pulse, peripheral pulses, pallor, clubbing, cyanosis, and edema. It also discusses examining the jugular venous pressure (JVP), palpating the apex beat and conditions where it may not be found, percussion of the heart, and auscultating the heart sounds and murmurs. The document is intended as a guide for medical students on performing the cardiovascular exam.
This document provides details on cardiovascular examination including cardinal symptoms, chest pain characteristics, breathlessness causes, palpitations description, syncope causes, and edema types. It also describes techniques for cardiovascular auscultation including listening locations, sounds, murmur characteristics like timing, intensity location, loudness, quality, pitch, radiation, and changes with maneuvers.
Cardiac physical exam and innocent murmurs presentationrajasthan govt
The document discusses examination of the cardiovascular system by assessing arterial pulses. It defines arterial pulses and describes how to evaluate the rate, rhythm, volume, and character of pulses at different arterial sites. Specific pulse abnormalities are also outlined, such as pulsus paradoxus and dicrotic pulse. The summary evaluates arterial pulses to examine cardiovascular function.
This document provides guidance on performing a cardiovascular examination, including:
1. Examining the general appearance, vital signs, jugular venous pressure, peripheral edema, and hands of the patient.
2. Performing a local heart examination using the IPPA sequence of inspection, palpation, percussion, and auscultation of the four heart valve areas.
3. During auscultation, commenting on heart sounds, extra sounds like murmurs, and lung bases.
Cardiac physical exam and innocent murmurs presentation june 2020rajasthan govt
The document discusses examination of the cardiovascular system by assessing arterial pulses. It defines arterial pulses and describes how to evaluate the rate, rhythm, volume, and character of pulses at different arterial sites. Specific pulse abnormalities are also outlined, such as pulsus paradoxus and bisferiens pulse, which provide clues to underlying cardiovascular conditions like constrictive pericarditis or aortic stenosis. The summary evaluates arterial pulses to examine cardiovascular function.
1. The document describes the examination of a patient with signs of infective endocarditis including splinter hemorrhages, purpura, and Janeway lesions.
2. Finger clubbing is described in four stages from increased ballotability to thickening of the distal finger resembling a drumstick. Clubbing can be caused by various cardiac and respiratory conditions.
3. The examination of arterial pulses, jugular venous pulsation, carotid pulsation, apical impulse, heart sounds, murmurs and additional sounds are outlined.
This document provides information on cardiovascular examination, specifically examining the arterial pulse. It defines an arterial pulse as the pressure wave felt along peripheral arteries with each left ventricular contraction. Key points discussed include the rate, rhythm, volume, and character of the pulse. Specific pulse abnormalities are defined, such as pulsus paradoxus, dicrotic pulse, and pulsus alternans. Methods for examining different peripheral pulses like the radial, brachial, femoral, and carotid are outlined.
Clinical assessment of the cardiovascular system. Featured: Main symptoms and physical exam. References from Bates' guide to physical examination and history taking and Medex app.
This document provides an overview of how to examine the cardiovascular system through history, examination of vital signs, inspection, palpation, and auscultation. It details how to examine the pulse, blood pressure, jugular venous pulse, apex beat, and heart sounds. It describes normal findings as well as abnormalities that may be found and how to characterize different types of murmurs. The examination is supported by additional tests like ECG, chest x-ray, and echocardiogram.
This document provides an overview of various diagnostic tools used in cardiology, including electrocardiography (ECG), non-invasive cardiac imaging modalities like echocardiography and nuclear imaging, and invasive diagnostic procedures like cardiac catheterization and coronary angiography. It describes the basic principles, clinical applications, and abnormalities detected by each diagnostic modality.
Brief Presentation on clinical examination of Cardio Vascular System with Report of Normal case
references:
macleod's clinical examination 13th edition
hutchinson clinical methods
This document provides information on examining the cardiovascular system. It discusses the anatomy of the heart and describes how to examine jugular venous pressure. A normal jugular venous pressure is less than 8 cm above the right atrium. The document outlines the steps to measure jugular venous pressure including inspecting the internal jugular vein and measuring the highest point of pulsation in relation to the sternal angle. Elevated jugular venous pressure indicates abnormal cardiac function or pressures in the right heart.
The document provides guidance on performing a cardiovascular examination, including taking a history, inspecting the precordium, palpating the chest, and auscultating heart sounds. It details the specific areas to examine by palpation and auscultation, and what abnormalities in findings may indicate different cardiovascular conditions. The examination techniques are described step-by-step, emphasizing the importance of patient comfort and obtaining accurate information.
This document provides an overview of cardiac anatomy, physiology, and assessment. It begins with a description of the heart's structure including the coronary arteries and conduction system. Key concepts are explained such as the cardiac cycle, output, and factors that determine stroke volume like preload, afterload, and contractility. Common symptoms of cardiovascular disease are outlined. The document then details the steps and focus of a cardiac assessment including gathering a health history and examining vital signs, skin, neck, heart, lungs, and abdomen. Potential exam findings and complications are also noted.
Clinical examination of Radial pulse by Pandian M, Tutor, Dept of Physiology,...Pandian M
Introduction
Ideal graph which represented radial pulse
Importance
Method of examination
Procedure
The following aspects (parameters) of the pulse are studied
Precautions:-
Discussion
Applied aspects
Other peripheral pulses
This document provides an overview of cardiovascular system assessment for nursing students. It begins by outlining the learning objectives which are to review cardiovascular anatomy and physiology, learn how to take a cardiac health history and perform a physical exam, and understand diagnostic tests. The document then describes the anatomy of the heart and vessels, heart sounds, heart rate, peripheral vascular assessment, cardiac function assessment including history taking and physical exam, and various diagnostic tests including ECG, echocardiogram, stress test, and hemodynamic monitoring.
Examination of cardiovascular system in PediatricsBirhanu Melese
The paediatrics cardiovascular exam can be a logistical minefield, requiring a good understanding of cardiac anatomy and possible congenital anomalies. With babies especially, it’s important to be opportunistic with your examination – doing the three ‘quiet things’ first: auscultation of heart sounds, auscultation of breath sounds and palpation of femoral pulses.
This document provides information on assessing the cardiovascular system. It begins with an introduction on the importance of cardiovascular assessment by nurses. It then covers anatomy and physiology of the heart, including the valves and blood circulation. Physical examination techniques are outlined, including inspection, palpation, percussion and auscultation. Common abnormalities that may be found on assessment are listed. Finally, additional investigation methods are mentioned, such as electrocardiograms, blood tests and cardiac imaging.
This is presentation of basics of Electrocardiography and its fundamentals specially for beginners of medical professions. The content is intended keeping first year medical professionals as center point.
DIFFERENT PULSE SITES (pulse -introduction & images)martinshaji
The document discusses different pulse sites in the body. It defines a pulse as the wave of blood in the artery created by the contraction of the left ventricle during each cardiac cycle. There are peripheral pulses that can be felt over bony prominences like the carotid, radial, and popliteal arteries, and apical pulses that are monitored with a stethoscope over the heart apex. Key parameters of pulses include rate (bradycardia is under 60 beats/minute, tachycardia is over 100), and rhythm or time interval between beats. Common pulse sites that can be checked include the temporal, carotid, brachial, radial, femoral, popliteal, and dorsalis pedis arteries.
This document presents a case of multivalvular heart disease involving the mitral, aortic, and tricuspid valves. On examination, the patient had signs of mitral and aortic stenosis as well as aortic and tricuspid regurgitation. The clinical diagnosis was severe mitral restenosis, severe aortic stenosis, moderate aortic regurgitation, and functional tricuspid regurgitation, likely due to rheumatic heart disease. The document then discusses various topics related to multivalvular heart disease including common causes, factors modifying presentation, features of individual valve lesions, and combinations of lesions.
MULTI VALVULAR HEART DISEASE clinical presentation Kurian Joseph
This document presents a case of multivalvular heart disease involving the mitral, aortic, and tricuspid valves. On examination, the patient had signs of mitral stenosis, aortic stenosis, moderate aortic regurgitation, and functional tricuspid regurgitation. The clinical diagnosis was severe mitral restenosis, severe aortic stenosis, and complications of pulmonary hypertension. Common causes, clinical presentations, and assessments of various combinations of multivalvular diseases are then discussed.
Importance of examination of Pulse & BP in children.pptxDr. Renesha Islam
This document provides information on examining pulse and blood pressure in children. It discusses what pulse is, how to take a pulse in different locations like the radial artery and brachial artery, and how to assess pulse rate, rhythm, volume, and character. It describes abnormal pulse findings like tachycardia, bradycardia, irregular rhythms, and abnormal pulse characters. It explains factors that can cause variations in pulse examination and outlines important information that can be learned from assessing the pulse.
This document discusses continuous murmurs, which are murmurs that begin in systole and continue uninterrupted through diastole. The main causes of continuous murmurs are high to low pressure shunts, such as a patent ductus arteriosus (PDA) or ruptured sinus of valsalva. Continuous murmurs can also be caused by rapid blood flow, such as in hyperthyroidism. The document describes the characteristics, locations, and distinguishing features of continuous murmurs from various underlying conditions.
This document provides an overview of techniques for examining the cardiovascular system in dogs, including:
1. Physical examination techniques like auscultation of heart sounds and palpation of the chest wall to detect murmurs, thrills, and abnormalities.
2. Diagnostic imaging tools like thoracic radiography to evaluate heart size and shape, and look for signs of pulmonary edema or effusion.
3. Electrocardiography to analyze heart rate, rhythm, and intervals to detect arrhythmias or chamber enlargement.
The document describes what each exam can reveal and how findings are interpreted to evaluate for heart disease and abnormalities.
Examination of the cardiovascular system involves inspection, palpation, percussion, and auscultation of various areas. During examination, the physician checks for abnormalities in pulse, jugular venous pressure, heart sounds, murmurs, thrills, and displacement of the apical beat which may indicate underlying conditions. Auscultation of heart sounds and murmurs at predefined locations can help identify common valvular diseases and shunts based on the timing and characteristics of the murmurs heard. Symptom analysis is also important to differentiate potential cardiac, pulmonary or other causes of chest pain, breathlessness, palpitations or syncope.
This document provides information on evaluating heart murmurs, including:
- Key areas to listen for different heart valves and sounds
- Techniques for describing murmurs by timing, shape, location, and intensity
- Common causes of different types of murmurs like ejection murmurs from aortic stenosis and early systolic murmurs from mitral regurgitation
- Using maneuvers to better hear murmurs or determine their source
It outlines the approach for a thorough auscultation of heart sounds and murmurs to identify underlying structural issues or abnormalities.
This document provides an overview of cardiac arrhythmias that may be seen in the surgical intensive care unit (SICU). It begins with definitions of normal sinus rhythm and mechanisms of arrhythmias including automaticity, ectopic foci, and reentry. Common arrhythmias are then described in more detail such as sinus bradycardia, atrial fibrillation, ventricular tachycardia, and various forms of heart block. Causes and management of arrhythmias are discussed with a focus on the relevant medical literature. Antiarrhythmic drug classes and their uses and side effects are also reviewed.
This document provides details on examining patients with cardiovascular symptoms. It describes how to take a history, including presenting symptoms, previous illnesses, habits, and family history. The physical exam involves inspection, pulse examination, blood pressure measurement, jugular vein examination, chest examination, and heart auscultation. Specific cardiovascular conditions can cause chest pain, dyspnea, fatigue, palpitations, and syncope. Findings on exam include pulses, jugular vein pressure, heart sounds, murmurs, and peripheral signs. The goal is to evaluate symptoms, signs, and history to understand a patient's cardiovascular condition.
Cardiac Physical Exam and Innocent Murmurs Presentation.pdfsonijayprakash28
Dr. J P Soni discusses the physical examination of the cardiovascular system. He describes in detail how to assess arterial pulses through palpation of different arteries such as the radial, brachial, femoral, carotid, and dorsalis pedis. Key aspects of pulse examination include evaluating rate, rhythm, volume, character, and comparing pulses between different locations. Abnormal pulse findings can provide clues about underlying heart conditions such as aortic stenosis or heart failure. Blood pressure measurement techniques are also outlined.
This document provides an overview of cardiac arrhythmias, including definitions and descriptions of normal sinus rhythm and various arrhythmias. It discusses the cardiac conduction system and mechanisms that can cause arrhythmias, such as abnormal impulse formation or conduction. Specific arrhythmias summarized include sinus bradycardia, sinus tachycardia, premature atrial contractions, supraventricular tachycardia, atrial fibrillation, atrial flutter, and atrial tachycardia. For each arrhythmia, the document provides information on heart rate, rhythm, P wave presence/morphology, and other ECG characteristics.
This document provides an overview of how to perform a cardiovascular examination, including assessing the pulse, blood pressure, jugular venous pressure, auscultation of heart sounds, characterization of murmurs, and examination of peripheral vessels and limbs. It describes the approach to inspection, palpation, percussion, and auscultation of the heart and vessels, as well as common symptoms of heart disease. Classification of murmurs, heart sounds, and jugular venous pressure are also outlined.
Heart murmurs can be produced by turbulence in blood flow caused by abnormalities in heart valves or structures. A murmur is described by its timing in the cardiac cycle, location, intensity, quality, and radiation pattern.
A mid-systolic murmur is the most common murmur and can be caused by ventricular outflow obstructions like aortic stenosis, dilation of the aorta/pulmonary trunk, accelerated flow, or innocent murmurs from normal anatomical variations. Diastolic murmurs include early diastolic murmurs like aortic regurgitation and high-pressure pulmonary regurgitation, and mid-diastolic murmurs caused by stenosis of the mitral or tricuspid valves. Flow murmurs
The arterial pulse reflects left ventricular ejection of blood into the aorta. The pulse is determined by factors such as stroke volume, ventricular contractility, and the properties of the arteries. The central pulse contour changes as it is transmitted peripherally due to wave reflections and arterial damping. Abnormal pulses include pulsus parvus, tardus, and anacrotic pulses seen in aortic stenosis. Other abnormal pulses are dicrotic, bisferiens, collapsing, and paradoxus pulses related to various cardiovascular abnormalities. Physical examination of peripheral arteries allows evaluation of the pulse and signs of cardiovascular diseases.
A 53-year-old man presented with shortness of breath and was found to have severe mitral stenosis, moderate aortic stenosis, severe aortic regurgitation, and moderate pulmonary hypertension. He underwent double valve replacement and is now doing well. Physical examination revealed an irregular pulse, murmurs, and cardiomegaly on chest x-ray, and echocardiogram demonstrated the valvular abnormalities.
Systolic murmurs can occur in various parts of the cardiac cycle. Ejection systolic murmurs are most common, occurring after some time from S1 and peaking in mid-systole or later. Causes include ventricular outflow obstruction, dilation of the aorta/pulmonary trunk, or accelerated flow. Pan systolic murmurs occur throughout systole due to pressure gradients across valves. Mitral regurgitation and ventricular septal defects cause holosystolic murmurs. Early systolic murmurs begin with S1 and peak in early systole, often caused by small VSDs or innocent murmurs. Late systolic murmurs in mitral valve prolapse occur as leaflets overshoot in late syst
1. Arrhythmias are disorders of cardiac impulse formation and propagation that are broadly divided into tachyarrhythmias and bradyarrhythmias.
2. Common arrhythmias include atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular tachycardia, heart blocks, and ventricular fibrillation.
3. Treatment depends on the type of arrhythmia but may include medications, cardioversion, ablation, pacemakers, or implantable cardioverter-defibrillators.
The document provides information about cardiac auscultation and heart sounds. It discusses the anatomy and function of the heart chambers and valves. Four main heart sounds (S1, S2, S3, S4) are described in detail, including their locations, timing in the cardiac cycle, and pathological variations. Additional extra heart sounds like clicks, murmurs and gallops are also outlined. The importance of assessing six characteristics of heart sounds during auscultation is highlighted. Instructions are given on performing a cardiac exam and auscultating the heart in multiple positions and with different parts of the stethoscope.
The document provides information on performing a precordial examination, including history, examination technique, inspection, palpation, and auscultation. It discusses examining the apical impulse in detail, including location, duration, size, force, and variations such as absence, tapping, hyperdynamic, and heaving. Characteristics and causes of a displaced or diffuse apical impulse are also covered.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
2. THE HISTORY
The cardinal symptoms of CVS involvement are –
Dyspnea
Chest pain
Palpitation
Fatigue
Syncope
3. ARTERIAL PULSE
Pulse is a Greek word meaning “move to and fro”.
Defined as a wave produced by cardiac systole traversing in the peripheral direction in the arterial
tree at a rate(5m/s) faster than the column of blood(.5m/s).
Characteristics of pulse wave pattern –
In the peripheral arteries –
Anacrotic notch disappears
Incisura in descending limb is replaced by dicrotic notch followed by dicrotic wave
4. Examination of the arterial pulse and its evaluation
All the major arterial pulses should be bilaterally examined for –
o Rate
o Rhythm
o Character
o Volume
o Condition of the arterial wall
o Radio-radial and radio-femoral delay
Besides palpation, auscultation of major arteries should be performed to look
for audible bruit.
5. Measurement of Blood Pressure
SBP – Maximum pressure exerted during systole. Normal SBP <120 mm Hg.
DBP – Minimum pressure exerted during diastole. Normal DBP <80 mm Hg.
PP – Difference between SBP and DBP. Normal average PP is 40 mm Hg.
MBP – Average blood pressure throughout the cardiac cycle.
Sum of DBP and 1/3 of PP
Same for each organ and determines the regional blood flow through an organ
Normally ranges berween 95 – 100 mm Hg, with an average of 96 mm Hg
6. Sphygmomanometric measurements
Palpatory method without sphygmomanometer –
An approximation of SBP may be done by the amount of brachial artery compression required
to obliterate the ipsilateral radial pulse, as like :
When relatively mild compression obliterates the radial pulse SBP <120 mm Hg
When considerable compression required SBP may be >160 mm Hg
Palpatory method with sphygmomanometer
Auscultatory method –
This method requires proper understanding of the KOROTKOFF sounds in different phases with
adequate cuff size, proper technique and equipment.
In order to determine BP in basal condition, patient should avoid caffeine, exercise
and smoking for at least 30 mins and should be seated for at least 5 mins quietly and comfortably.
7. Jugular Venous Pulse Waves and Pressure
The bedside examination of JVP is done –
• To assess the waveform
• To assess approximately the mean RA pressure
Normal jugular venous wave pattern –
1. a wave : The first positive presystolic wave, occurs due to right atrial contraction
2. x descent : The systolic collapse, follows the a wave, occurs due to atrial relaxation
during atrial diastole
3. c wave : produced by – i) impact of carotid artery which is adjacent to the IJV, and ii)
upward bulging of the closed TV into the RA during RV isovolumic contraction.
8. Jugular Venous Pulse Waves and Pressure(contd.)
4. v wave : results from rise in RA pressure due to continued filling during ventricular
systole.
5. y descent : results from RA emptying during early diastole.
9. Cardiovascular System Examination
Inspection –
1. Examination of the chest –
I. Shape of the chest - In normal adults, it is bilaterally symmetrical
and elliptical in cross-section with transverse
diameter>anteroposterior diameter and has a subcostal angle of
about 90 Degree.
It may be distorted in various disorders –
Pectus Excavatum
Pectus Carinatum
Straight back syndrome
10. Cardiovascular System Examination(contd.)
ll. Cutaneous lesions –
a) Erythema marginatum seen over the trunk and proximal extremities in patients with ARF.
b) Spider nevi seen in the distribution of SVC in hepatic cirrhosis, Osler-Weber-Rendu syndrome
and pregnancy.
lll. Breast abnormalities –
a) Male gynecomastia as an adverse effect of digitalis, Klinefelter syndrome
b) Female hypomastia is a part of asthenic habitus in mitral valve prolapse
c) Widely spaced nipples associated with BROAD SHIELD CHEST are typical of Noonan
syndrome and Turner syndrome.
11. Cardiovascular System Examination(contd.)
IV. Distended vessels –
a) Veins : over anterior chest wall
With caudal flow – obstruction of SVC
With cranial flow – obstruction of IVC
b) Arteries : collateral vessels seen in interscapular, infrascapular and posterior
intercostal spaces in patients with COARCTATION OF AORTA called suzman sign.
They are palpable when the patient stands and bends forward with arms
hanging down by the sides
12. Inspection(contd.)
2. Examination of Precordium –
I. Precordial prominence with bulging of intercostal space not involving
the ribs – suggestive of PERICARDIAL EFFUSION.
II. Precordial prominence involving both intercostal spaces and ribs –
long standing cardiomegaly(usually develops before
puberty)usually due to RV hypertrophy.
III. Precordial bulging of non CVS origin – mediastinal new growths,
kypho-scoliosis, bronchogenic carcinoma.
IV. Visible pulsations(if any)
13. Palpation of The Precordium
1. Examination of the chest for confirmation of shape and distended vessels – Shape of
the chest noted during inspection is confirmed by taking measurements including
anteroposterior and transverse diameter.
2. Palpation for precordial tenderness –
Tenderness of costochondral junction – in TIETZE syndrome, which is important
to rule out MI in patient with chest pain.
May be associated with acute pancreatitis, acute myocarditis.
3. Palpation of the cardiovascular pulsations, sounds, thrills and rubs
14. Palpation of The Precordium(contd.)
Palpation for the cardiovascular pulsations is done at –
Cardiac apex
Left parasternal area – palpated for i) character(grade) of left parasternal
lift, and ii)palpable low frequency sounds(RV S3, RV S4 )
• The outer most and lower most
point of maximum impulse
• Palpated for size,character,extent
and thrills.
• Located 4th or 5th Intercostal space
at or inside MCL,<_ 10cm from
mid-sternal line.
• Confined to 1 intercostal space,
<3cm in diameter,lasts for <50% of
systole.
Grading of PSL As per Subjective & Objective method
Grade 1/3(mild) • Disappears with mild counter pressure
• Ill sustained,<1/3rd of systole
Grade 2/3(moderate) • Disappears/diminishes with moderate counter pressure
• 50% of systole but not throughout the systole
Grade 3/3 (severe) • Moderate counter pressure doesn’t diminish the PSL
• Throughout the systole
15. Palpation of The Precordium(contd.)
Left lower sternal area(tricuspid area)
I. Palpable low-frequency heart sounds : RV S3, RV S4
II. Palpable high-frequency heart sounds : opening snap of organic
TS.
III. thrills : systolic thrill of severe TR, diastolic thrill of organic TS.
Aortic and Pulmonary area
I. Palpable high frequency heart sounds
II. Thrills : systolic and diastolic thrill are looked for.
16. Palpation of The Precordium(contd.)
Sternoclavicular areas :
continuous/ systolic thrill may be palpable(Blalock-Taussig
shunt, PDA)
Epigastrium :
• The subxiphoid region allows the palpation of RV
• Pulsations may be due to aortic or hepatic in origin.
Ectopic areas
17. Cardiovascular Auscultation
The topographical areas of cardiac auscultation are –
Aortic area
Pulmonary area
Tricuspid area
Mitral area
In addition, auscultation should be regularly be carried out at:
The axillae
The back
Anterior chest on opposite side
Over the carotids
Above and below the clavicles
Over the peripheral arterial sites
18. Cardiovascular Auscultation(contd.)
Dynamic auscultation –
The impact of respiration on the heart sounds and murmurs should
be assessed routinely.
In selected cases, isovolumetric exercises, Valsalva maneuver, Muller
manuever and pharmacological manuevers(Amyl Nitrate inhalation)should
be employed.
The heart sounds –
They are characterized by intensity, pitch and quality.
S1 – signals the onset of ventricular contraction
S2 – signals the onset of ventricular diastole. Has 2 components: A2(first component),
P2(second component)
S3 – low frequency, mid-diastolic sound.occurs during rapid ventricular phase.
S4 – low frequency, late diastolic sound, occurs during atrial contraction.
19. Cardiovascular Auscultation(contd.)
Added sounds –
Openig snap – high frequency clicky sound generated in early diastole due to thickening and
deformity of the leaflets of AV valve. It implies thickened but mobile AV leaflets, high atrial
pressure or high velocity flow across the AV valves.
Tumour plop – high frequency early diastolic sound heard in atrial myxoma
Systolic ejection sounds – high frequency early systolic sound
Pericardial knock – low frequency early diastolic rapid filling sound characteristic of
CONSTRICTIVE PERICARDITIS.
Extracardiac sounds –
Pericardial rub(movement of parietal and visceral pericardium against each
other)
Pacemaker sounds
Mediastinal crunch
20. The Heart Murmurs
Defined as audible signals/vibrations of varying intensity, frequency, configuration
and duration detectable with the aid of stethoscope.
Characteristics of murmur –
1. Timing :
- systolic
- diastolic
- continuous
2. Location
3. Duration :
- short
- long
- holo
4. Intensity - grading
5. Pitch
6. Configuration
7. Transmission
8. Dynamic auscultation
Grade Character
1/6 Faintest mumur, can be heard only with special effort and
under optimal conditions
2/6 Soft of faint murmur
3/6 Moderately loud murmur without thrill
4/6 Very loud murmur with thrill
5/6 Extremely loud murmur, can be heard by edge of sthethoscope
but not if it is removed. Associated with thrill
6/6 Execptionally loud murmur, can be heard with stetho, without
contact on the chest wall, accompanied by thrill.
21. The Heart Murmurs(contd.)
Type of bedside manuevers in dynamic auscultation –
a) physical –
respiration, postural changes, isometric handgrip, Valsalva and muller manuever
a) Pharmacological –
by use of vasoactive agents such as amyl nitrate, methoxamine and
phenylephrine.
In central arteries ascending limb anacroti knotch disappears b/w percussion and tidal wave, descending limb no incisura replaced by dicrotic notch f/b dicrotic wave