Cardiovascular examination 1

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impaired fasting glucose

fasting blood glucose of ≥ 110 mg/dL

obesity

BMI of ≥ 30kg, or waist girth of >100 cm

high serum HDL cholesterol

> 60 mg/dL

palpation of pulses

30 secs with regular rhythm, 1-2 mins with irreg

apical pulse/PMI

5th interspace midclavicular vertical line

brachial pulse

best in infants

radial pulse

most common monitoring site

(N) adult HR

70 bpm; range 60-80 bpm

(N) newborn HR

120 bpm; range 70-170 bpm

tachycardia

>100 bpm

bradycardia

<60 bpm

irregular pulse

variations in force and frequenc; may be due to arrhythmias, myocarditis

weak, thready pulse

stroke volume, cardiogenic shock

bounding, full pulse

shortened ventricular systole and decreased peripheral p°; aortic insufficiency

aortic valve

2nd (R) ICS, sternal border

pulmonic valve

2nd (L) ICS, sternal border

tricuspid valve

4th (L) ICS, sternal border

bicuspid valve

5th (L) ICS, midclavicular area

S1 sound "lub"

(N) closure mitral &tricuspid valves; beginning of systole; dec in 1st degree heart block

S2 sound "dub"

(N) closure aortic & pulmonic valves; end of systole; dec in aortic stenosis

S3 sound

assoc with ventricular filling; occurs soon after S2

S3 sound

congestive (LV) heart failure in older individuals

S4 sound

assoc with ventricular filling and atrial contraction; occurs just before S1

CAD, MI, aortic stenosis, or chronic HPN

systolic murmur

bet S1 & S2. may be normal or may indicate valvular dse (mitral valve prolapse)

diastolic murmur

bet S2 and S1. Usu indicates valvular dse

thrill

ab(N) tremor accompanying a vascular or cardiac murmur; felt on palpation

bruit

adventitious sound or murmur (blowing sound) of arterial or venous origin

bruit

common in carotid or femoral arteries; indicative of atherosclerosis

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