Cardiac action potential Typically described cardiac action potential is that of the myocardial cell. Action potential of tissues like sinus node will be different and characterized by diastolic
Cardiac cycle Cardiac cycle consists of all events occurring in the heart during a systole and the following diastole. Clinically systole starts from the first heart sound and
Cardiac murmurs Cardiac murmurs are initially classified into systolic, diastolic and continuous. They can be timed in relation to the carotid pulse. A systolic murmur starts with or
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