Cardiovascular Assessment

Elizabeth Bruderle

Villanova University

Cardiac Assessment

Anatomy: Description and Position

Chambers: Atria & Ventricles.

Valves: Allow blood to flow in one direction.

Atrioventricular: Tricuspid and Mitral (closure creates S1).
Semilunar: Aortic and Pulmonic  (closure creates S2).

Great Vessels

Physiology

Electrical Stimulation: Automaticity

Sinoatrial (SA) node: Pacemaker

Cardiac Cycle: Ventricular activity

Systole: First heart sound/S1

Diastole: Second heart sound/S2

Split S2

S3& S4: Extra sounds

Developmental Variations

Infants/Children

Elderly

Assessment

History:smoking, stress, exercise, diet, meds, surgery, myocardial infarction, pain, dyspnea, fatigue, cough, palpitations, family history

Physical Assesment

Inspection: Color, symmetry, pulsations, lifts/heaves

Palpation: Precordium, Carotid and Apical pulses, Thrills

Auscultation: Supine (diaphragm & bell, all 5 sites); Left side-lying (bell at apex); Sitting (diaphragm, all 5 sites).

Peripheral Vascular

Assessment

History: pain, temperature and /or skin changes, cyanosis, redness, ulcers, occupation, smoking, varicose veins, family history

Physical Examination

Inspection: color, lesions, hair growth, edema, size, symmetry

 

 

Palpation: Distal to Proximal

temperature, texture, capillary refill, and moisture

Peripheral Pulses: location,

strength/amplitude (0-+4), bilateral symmetry, compare strength in upper and lower extremities

Auscultation: Bruits over carotids and abdominal aorta

Documentation

Apical impulse barely visible at 5th ICS, LMCL. AHR 72, regular. No palpable thrills. Carotid pulse consistent with apical pulse. S1 auscultated at mitral area. S2 loudest at 2nd ICS, RSB. Extremities warm, dry, no lesions. Peripheral pulses equal, +2.