ASSESSMENT OF

CARDIOVASCUL
AR SYSTEM
DR. GUL E MAHAM
(PT)
 CARDIOVASCULAR SYSTEM
(CVS) DISEASE SYMPTOMS
Dyspnea - shortness of breath
Orthopnea - the sensation of breathlessness in the
lying position, relieved by sitting or standing
Paroxysmal nocturnal dyspnea (PND) - a sensation of
shortness of breath that awakens the patient
Palpitations - feelings of having a fast-beating,
fluttering or pounding heart
Chest Pain/sweats - sign of heart attack
Syncope - a temporary loss of consciousness usually
related to insufficient blood flow to the brain
Peripheral edema - swelling of your lower legs or
hands
PHYSICAL
EXAMINATION
Inspection
Palpation
Percussion
Auscultation
 INSPECTION
Skin color to assess perfusion
Cyanosis is a bluish
discoloration of the skin, lips,
and nail beds and indicates
decreased perfusion and oxygenation.
Pallor is the loss of color, or paleness of the
skin or mucous membranes, as a result of
reduced blood flow, oxygenation, or decreased
number of red blood cells.
Normal person’s skin should be pink in color.
Jugular Vein Distension (JVD)
Inspect the neck for JVD that occurs
when the increased pressure of the
superior vena cava causes the jugular vein
to bulge, making it most visible on the
right side of a person’s neck.
JVD should not be present in the
upright position or when the head of bed
is at 30-45 degrees.
Precordium for
abnormalities
Inspect the chest area
over the heart (also
called precordium) for
deformities, scars, or
any abnormal pulsations
the underlying cardiac
chambers and great
vessels may produce.
Extremities
Note Color, Movement
Note any presence of edema.
Peripheral edema is swelling that can be
caused by infection, thrombosis, or
venous insufficiency due to an
accumulation of fluid in the tissues.
Deep Vein Thrombosis (DVT): Assess
for size, color, temperature, and for
presence of pain in the calves.
Unilateral warmth, redness, tenderness,
swelling in the calf, or sudden onset of
intense, sharp muscle pain that increases
with dorsiflexion of the foot is an
indication of a DVT (Homans sign)
 PALPATION
Precordial movements should be evaluated
at the apex (mitral area)
A heave or lift is a palpable lifting sensation
under the sternum and anterior chest wall to
the left of the sternum that suggests severe
right ventricular hypertrophy.
A thrill is a vibration felt on the skin of the
precordium or over an area of turbulence, such
as an arteriovenous fistula or graft
Capillary refill: Assess capillary refill
by compressing the nail bed until it
blanches and record the time taken for the
color to return to the nail bed.
Normal capillary refill is less than 3
seconds.
Edema: Palpate the area to determine if
the edema is pitting or non-pitting.
Press on the skin to assess for indentation,
ideally over a bony structure, such as the
tibia. If no indentation occurs, it is referred
to as non-pitting edema. If indentation
occurs, it is referred to as pitting edema
 PERCUSSION
5th intercostal space at the left anterior axillary line
Normal findings would be resonance because you will be over
lung tissue
Next, percuss the mid-clavicular line and the left sternal
border, Advance to the 3rd and 2nd intercostal space on the
left side
Should change from resonance to dullness as you percuss over
the heart
AUSCULTATION
A Z-pattern is recommended
Aortic area - 2nd ICS to right of sternum
(closure of the aortic valve loudest here)
Pulmonary area - 2nd ICS to left of
sternum (closure of the pulmonary valve
loudest here)
Tricuspid - 4th ICS left of sternal border
(closure of tricuspid valve)
Mitral - 5th ICS left of the sternum just
medial to MCL (closure of mitral valve)
REFERENCES
Chapter 01, Assessment,
Physiotherapy For Respiratory And
Cardiac Problem By Jennifer A
Pryor, Barbara A Webber