Cardiac Examination

a specification of cardiac exam which will see you pass the GSM OSCEs


General inspection of patient (weight loss, veins, plethora, cyanosis, breathing)


inspect hands
inspect nails
inspect face
inspect mouth
inspect conjunctiva
check radial pulses
compare radial/radial & radial/femoral pulses
check for collapsing pulse


exposes chest
places bed at 45 degrees
checks JVP
checks hepatojugular reflux
palpates both carotids


checks anterior chest for thrills and heaves
palpates apex beat
specifies apex beat position
auscultates heart sounds in appropriate valve areas
auscultates carotids
accentuate heart sounds - roll onto left side for apex
accentuate heart sounds - sitting forward for apex & base
accentuate heart sounds - inspiratory/expiratory modulation of S2
uses bell for mitral/tricuspid areas
uses diaphragm for mitral/tricuspid areas
percusses posterior chest (effusions)
auscultates posterior chest (added sounds)
checks for sacral oedema


percusses liver borders
checks femoral pulses
checks popliteal pulses
checks calves for heat, swelling, tenderness
checks dorsalis pedis pulses
checks posterior tibial pulses
checks for peripheral oedema

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