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On inspection of the precordium, there is no precordial bulge (Precordium looks normal in shape). Apical impulse is visible 1 cm lateral and inferior to the left nipple. No visible pulsations seen (JVP, Supraclavicular, suprasternal, LLSB, epigastric). No scar marks (Incision of CABG, mitral valve replacement, pacemaker) and puncture marks (Pericardiaocentesis) seen . No dilated veins seen.
On palpation, Apex beat is located 1
cm lateral to the midclavicular line in the 5th ICS. (After
measuring with a scale.) The character of apical impulse is hyperdynamic (heaving/
tapping/ hyperdyanamic and hypodynamic).
No palpable S3/S4 and thrills.
No thrill and palpable S3 over the
tricuspid area.
No heave over the LLSB.
No palpable P2. No thrill felt over
the aortic and pulmonary area. No thrill radiating along the carotid and Infraaxillary
area.
On ausculatation, Loud S1(soft/loud)
is heard at the apex. S2 is heard. (there is no splitting of S2 and no audible
P2). S3and S4 were not audible. No murmur(diastolic/systolic), no added sound(opening
snap, click), no precordial rub and knock noted.
(If murmur present)
High pitch (High/Low) Mid (Early/mid/late)
Systolic Murmur (Systolic/ Diastolic) of Grade III(Grade of murmur) is heard over the apex (site
of auscultation) at the peak of expiration (Inspiration/ Expiration) in the
left lateral position (forward stooped/ left lateral position) with radiation to
axilla(abdomen/ along carotids.)
Note: All the things placed in
brackets are the alternatives that can be used to describe certain cardiac
condition and its corresponding findings.
Abbreviations
CABG coronary Artery bypass graft
ICS intercostal space
JVP jugular venous pressure
LLSB left lateral sternal border
P2/A2 pulmonary second heard sound /
aortic second heart sound
S1/S2/S3/S4 Heart Sounds.
| Abdominal | Respiratory | Cardiovascular | Nose and PNS | Oral Cavity | Ear | Digital Rectal Examination | Ulcer |
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