A Cardiovascular Exam Checklist PDF

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Cardiovascular Examination Check List

Skill

Not done (0)

Partially done (1)

Well done (2)

Not applicable ()

Remarks

1. General: a. b. c. d. e.

The patient look ( well → sick) In respiratory distress or not? In pain or not? On O2 therapy or I.V. therapy? The position of the patient

2. Vital Signs: a. b. c.

Blood pressure in supine and standing position Heart rate Temperature & respiratory rate

3. Hands: the presence or absence of: a. b. c. d.

Cyanosis Clubbing Splinter hemorrhage Oslar’s & Janway lesions

4. Pulse: a. b. c. d. e. f. g.

Rate Character Volume Rhythm Peripheral pulses Radio-radial or radio-femoral delay Condition of arterial wall

5. Face: a. b. c. d. e. f. g. h.

Signs of hyperlipidemia (Arcus, xantholasma) Congenital anomalies like (Down’s syndrome) Pallor Gum hygiene Observe the presence of teeth caries High arched palate Fundoscopic examination (Roth’s spot) Faci’s mitralis

6. J.V.P.: a. b. c.

d.

Position of the patient How to localize Internal Jugular Vein (between the two heads of sternocledo mastoid muscle). How to confirm Internal J. V. versus carotid artery (change with respiratory cycles, change with position, not palpable, positive hepatojagular or abdomen jagular reflux, direction of flow, accrudability). When Internal Jugular Vein is confirmed then the student should be able to tell the following: 1) Height properly (correct position & correct use of rulers). 2) Wave form if one of the major waves (A & V) is absent or abnormal), and be able to use the principal of palpating carotid or auscultating to differentiate a form V wave. The presence or absence of Kussmal’s sign.

1

Skill

Not done (0)

Partially done (1)

Well done (2)

Not applicable ()

Remarks

7. Precordial examination:

Inspection: a. b. c. d.

abnormal impulses abnormal shape of chest surgical scars (CBG) or pacemaker pocket if apex beat in visible

Palpation: a.

b. c. d.

Apex beat: (site, character, volume), the student should be able to perform the correct technique how to localize the normal apex beat, and to turn the patient on left side if failed to feel apex beat at flat position. How to palpate for left parasternal heave. How to feel for thrills How to feel for palpable sounds.

Auscultation: a. b. c. d.

e.

S1: character, volume S2: character, volume, splitting Pressure or observe of S3 or S4 Pressure or observe of the other added sounds like: opening snaps, pericardial rub, systolic clicks. Listen to murmur and be able to time it, define the character, loudness 1-6, relation with respiration, position and certain maneuvers like hand grip.

8. Finally the student should: a. b. c.

Listen to chest for the signs for congestion Check for hepatomegaly as a sign of right side heart failure and check for ascitis. Check for lower limb edema

This checklist was prepared by Dr. Abdullah Assiri

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