Overview
Cardiovascular examination combines assessment of general appearance, pulse, blood pressure, jugular venous pressure, precordium, heart sounds, murmurs, and peripheral circulation.
The examination should be interpreted together with the history and presenting symptoms.
Always assess the patient globally before focusing on the heart: perfusion, respiratory effort, edema, and overall appearance provide important clues to cardiovascular disease.
Pulse & Blood Pressure
Pulse assessment includes rate, rhythm, volume, character, and symmetry. Differences between limbs can suggest important vascular or structural disease.
Blood pressure should be measured using an appropriately sized cuff and interpreted in the clinical context.
JVP & Precordium
Jugular venous pressure provides information about right atrial pressure and systemic venous congestion.
Inspection and palpation of the precordium can identify a displaced apex, heaves, or thrills.
Auscultation
Auscultation assesses S1, S2, additional heart sounds, and murmurs. Murmurs should be characterized by timing, location, radiation, intensity, pitch, and response to maneuvers.
A murmur should never be described simply as “present”; its timing and radiation often provide the diagnostic clue.
Clinical Pearls
A good cardiovascular examination follows a sequence: general appearance → pulses → BP → JVP → precordium → heart sounds → murmurs → peripheral signs.
END OF REVIEW
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