Additional heart sounds Clicks: Clicks may be divided into ejection and non-ejection clicks. The click of mitral valve prolapse is a non-ejection click. It is typically mid systolic.
Heart sounds Two normally heard heart sounds are the first heart sound (S1) and second heart sound (S2). Second heart sound has two components – aortic (A2) and
Auscultatory areas Precordium is generally divided into four auscultatory areas, but other areas may be checked in specific situations. The common auscultatory areas correspond to the locations at
Palpation of precordium and adjacent areas Palpation initially confirms the findings of inspection and further looks for new findings. Apex beat: Apex beat is defined as the lowest
Inspection of precordium Precordial examination starts with inspection, though inspection and palpation are often combined in regular practice. Some of the features to look for are: Sternal deformities:
Jugular venous pulse (JVP) Assessment of jugular venous pulse has to be done in the internal jugular vein though a beginner is often tempted to use the external
Examination of the pulse Though the most commonly examined pulse is the radial, to check some of the characteristics, a more proximal pulse like the brachial or carotid
General examination – hands and feet Cyanosis and pallor can be noted in the tips of the digits. Severe jaundice may be visible in the palms and soles,
General examination – eyes and facial dysmorphism Clinically examination is guided by the symptoms. Unless the history is not correlated with findings, important diagnostic possibilities may be missed.
Palpitation Palpitation is undue awareness of one’s own heart beats. The commonest cause of palpitation is simple anxiety. Palpitation can occur with or without structural heart disease. It