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
Hemoptysis and cyanosis Hemoptysis Hemoptysis or spitting out blood is usually a symptom of lung disease, but can occur in certain heart diseases like mitral stenosis and Eisenmenger
Edema Edema due to cardiac failure is usually dependent edema with accumulation of fluid in the feet and ankle region. It will be over the sacrum in recumbent
Fatigue and syncope Fatigue Fatigue is a nonspecific symptom which can occur in multiple disorders. In heart disease, fatigue is often due to low cardiac output and may
Breathlessness Breathlessness (dyspnea) is another important symptom of heart disease. It can occur at rest or with exercise. Breathlessness at rest usually indicates a more severe disease. It