Cardio Assessment Geeky Medics
Cardio Assessment Geeky Medics
Introduce yourself Explain what you would like to examine Gain consent Place patient at 45 with chest exposed Ask if patient has any pain anywhere before you begin!
General Inspection
Bedside for treatments or adjuncts GTN spray, O2, Tablets, Wheelchair, Warfarin Comfortable at rest? SOB Malar Flush Chest for scars & visible pulsations Legs for harvest site scars and peripheral oedema
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Hands
Temperature - poor peripheral vasculature
Capillary refill should be <2 seconds Colour cyanosis Clubbing Splinter haemorrhages, Jane-way lesions, Oslers Nodes infective endocarditis Palmar Erythema hyperthyroidism, pregnancy, polycythaemia Nicotine Staining smoker
Pulses
Radial Pulse rate & rhythm Radial-Radial Delay aortic coarctation Collapsing Pulse aortic regurgitation
BP narrow pulse pressure = Aortic Stenosis | wide pulse pressure = Aortic Regurgitation Carotid character & volume JVP measure and also possibly carry out hepatojugular reflex
Face
Eyes conjunctival pallor, jaundice, corneal arcus, xanthelasma
Palpation
Apex beat 5th intercostal space, mid clavicular Heaves- left sternal edge seen in left & right ventricular hypertrophy Thrills Palpatable murmurs over aortic valve & apex
Auscultation
Listen over 4 valves - ensure palpation of carotid pulse to determine first heart sound Roll onto left side & listen in mitral area mitral stenosis Lean forward & listen over aortic area- aortic regurgitation Carotids - radiation of aortic stenosis murmurs & bruits Lung bases pulmonary oedema Sacral Oedema & Pedal Oedema
Thank Patient Wash hands Summarise Findings Say you would Assess peripheral pulses Carry out an ECG Dipstick urine Bedside Blood Glucose Fundoscopy
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