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Cardiovascular Physical Examination
Blood pressure: upright and supine position to compare the blood pressure. When going from supine to sitting position, there is no changes or decrease in blood pressure or dizziness.
Neck veins: patient turned her head to the right, no jugular vein distention observed at 30-35 degrees. Jugular venous pressure measured at 30-45 degrees, under 3 cm which is normal.
Carotid pulses palpated bilateral: no thrill. Auscultation with bell and diaphragm, no bruit.
Chest and trunk:
Inspection:
no visualized chest wall abnormalities. Sternum at midline. No precordial pulsations. No aortic abdominal pulsations.
Palpation:
No thrill, heaves or lifts in the aortic, pulmonary, Erbs point, tricuspid and mitral area.
Point of maximum intensity (PMI) : 5th intercostal space at the left midclavicular line.
Aortic valve: 2nd right intercostal space. Pulmonic valve : 2nd left intercostal space. Erb’s point: 3rd left intercostal space. Tricuspid: 4th left , mitral 5th left intercostal space.
Auscultation:
S1 and S2 present. Regular rhythm and rate. Auscultation of Aortic, Pulmonary, Erb’s Point, tricuspid and mitral valves no bruits.
Physiologic splitting of S2 occurs due to unsynchronized closure of pulmonary and aortic valves during inspiration
Abdominal aorta: no thrills/bruits.
Peripheral exam:
Extremities without visual abnormalities, skin is warm, no jaundice, no edema, no varicose veins. Radial pulse: bilateral equal grade 3+. Brachial pulse: bilateral equal grade 3+. Femoral pulse: bilateral: bilateral equal grade 3+. Popliteal pulse bilateral equal grade 3+ Dorsalis pedis pulse bilateral equal grade 3+. Posterior tibial pulse bilateral equal grade 3+
Capillary refill in finger and toes:< 2 sec
Fingers: No clubbing, cyanosis, tar staining or splinter hemorrhages.
Expectations
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References: 2 high-level scholarly references within the last 5 years in APA format.
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