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Cardiology Examination 2025

The document outlines the cardiology examination process, including inspection, palpation, percussion, and auscultation techniques. It details signs of various cardiac conditions such as ventricular enlargement, pulmonary hypertension, and the characteristics of heart murmurs. The examination findings are categorized by specific areas and symptoms, providing a comprehensive guide for assessing cardiac health.

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abdo fathy ua
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171 views4 pages

Cardiology Examination 2025

The document outlines the cardiology examination process, including inspection, palpation, percussion, and auscultation techniques. It details signs of various cardiac conditions such as ventricular enlargement, pulmonary hypertension, and the characteristics of heart murmurs. The examination findings are categorized by specific areas and symptoms, providing a comprehensive guide for assessing cardiac health.

Uploaded by

abdo fathy ua
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Cardiology examination

(Dr. Osama Salah)

(0)
Cardiology examination

Combined inspection and palpation


 Precordial bulge >>> ……… long standing cardiomegaly in CHD ………….
 Scar of previous operation and dilated veins
o Midline sternotomy scar “open heart surgery”
o Lateral thoracotomy scar

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 Apex
o Site: lowermost outermost visible and palpable cardiac beat
 Normally >>> 5th space inside MCL
 LV enlargement >>> shift apex out and down
 RV enlargement >>> shift apex out
o Area:
 Localized: felt in one space = LV ++
 Diffuse: felt in more than one space = RV ++
o Character: Normally gently touching your fingers (no special ccc)
 Hyper dynamic: volume over load (AR, MR, VSD)
 Sustained: pressure overload (AS)
 Slapping: weak, palpable S1 (MS).
o Thrill >>> MR or MS

 Other areas:
o Suprasternal notch:
 Pulsations >>> hyperdynamic circulation
 Thrill >>> AS
o Aortic area:
 Pulsations >>> aneurysm
 Thrill >>> AS
o Pulmonary area:
 Pulsation >>> P++
 Palpable S2 = diastolic shock >>> P++
 Thrill >>> PS
o Left parasternal area:
 Pulsations >>> RV++
 Thrill >>> VSD
o Epigastric pulsations:
 From aorta >>> …………………………..………………………….
 From right ventricle >>> …………………………..………………..
 From liver >>> …………………………………………….………….

‫خللى بالك‬
 Right ventricular enlargement
o Apex >>> shifted outwards + diffuse
o Epigastric pulsations
o Left parasternal pulsation

‫خللى بالك‬
 Left ventricular enlargement
o Apex >>> shifted down and outwards
o Localized

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‫خللى بالك‬
 Pulmonary hypertension
o Visible pulsation in pulmonary area
o Palpable pulsation in pulmonary area
o Palpable S2 in PA: Diastolic shock
o Loud pulmonary component of S2 over PA

Percussion
 Dullness in A1 >>> aortic root dilatation “aneurysm or systemic HTN”
 Dullness in pulmonary area >>> pulmonary hypertension
 Dullness on right side of sternum >>> right atrial enlargement
 Dullness outside the apex >>> pericardial effusion
 Bare area: wide dullness in pericardial effusion + resonant in emphysema

Auscultation
 S1 over the apex: ……………………………………………………………
 S2 over the base: ……………………………………………………………
 Murmur : ‫ بالتفصيل‬mment on murmur:
 Character: harsh, soft, blowing, rumbling and musical
 Time: systolic (pan or ejection systolic) or diastolic (early or mid-diastolic)
 Site of maximum intensity
 Propagation
 Intensity (grade)
 Relation to position

Grade 1/6 Barely audible ‫مسموع بصعوبه‬


Grade 2/6 Audible but soft ‫مسموع بس واطى‬
Grade 3/6 Easily audible + No thrill ‫ مفيش رعشه‬+ ‫مسموع بسهوله‬
Grade 4/6 Easily audible + thrill ‫ فيه رعشه‬+ ‫مسموع بسهوله‬
Grade 5/6 4 + still heard with stethoscope lightly on chest ‫سماعه المسه خخيف‬
Grade 6/6 5 + still heard with the stethoscope off chest wall ‫سماعه مش المسه‬

(3)

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