Cardiovascular Examination

Clinical Presentations 

Core Presentations

1. Aortic Stenosis (& Aortic sclerosis)

2. Mitral Regurgitation

3. Metallic Aortic Valve Replacement

4. Metallic Mitral Valve Replacement

5. Ventricular Septal Defect

6. Aortic Regurgitation 

7. Mitral Stenosis

8. Marfan's Syndrome, Ehlers Danlos syndrome (EDS) - MR, AR

9. Atrial Fibrillation

10. Normal examination

Stable signs that can present

• Dextrocardia

Cardiovascular Examination

6 minutes

Introduction + End of bed

WINDEC:

• Wash hands

• Introduce yourself

• Ask for name & date of birth

• Explain the examination and ask for consent

Exposure

• It is important to ensure adequate exposure for inspection- 45 degrees lying on bed, ask for consent for a male to be topless and female to be down to bra

End of the bed inspection

Peripheral Examination

Lower limbs

• Peripheral oedema

• Scars from vein harvesting for CABG

Hands

• Finger clubbing

• Tobacco staining

• Peripheral hypoxia

• Fine tremor

• CO2 retention tremor

• Atrial Fibrillation

• Collapsing pulse- check for shoulder pain prior [fail station if not]

Arms

• Lines or fistulas

Neck

• JVP

• Cervical lymphadenopathy

Face

• Conjunctival pallor

• Central cyanosis (tongue)

Chest 

Anterior

Inspection

• Scars: sternotomy

• Work of breathing, central cyanosis

Palpation

• Thrills in four heart areas

• Heaves- left ventricular, right ventricular

• Apex beat

Auscultation

• Heart Sounds 

  • • Time with carotid pulse

  • Bell in all four areas

  • Diaphragm in all four areas

  • Consider inspiratory/ experiatory exacerbation

  • Auxilla and carotid

• Manouvres

  • Mitral stenosis

  • Aortic regurgitation

Posterior

• Palpate for sacral oedema

• Chest crackles

See Respiratory Examination for full breakdown. 

Written in 2026