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CV exam: what to expect?

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A cardiovascular exam includes visual observations, pulse testing, manual palpation, and listening to the heart with a stethoscope. Doctors look for abnormalities that could indicate heart disease, and also check for high blood pressure and heart murmurs. Patients typically undergo the exam after experiencing chest pain or shortness of breath.

A cardiovascular exam typically involves five physical observations. They include: a visual examination of the face, neck and hands; testing jugular vein pulses; examination of the great arteries; manual palpation; and listening to the heart with a stethoscope. A doctor looks for any abnormalities in each step of the cardiovascular exam that could indicate heart disease.

Patients typically undergo a cardiovascular examination after experiencing chest pain or shortness of breath. Doctors look for visual facial redness, sweating, and signs of jaundice. Jaundice may be indicated by yellowing of the eyes, especially under the upper lids. Rings in the cornea could also indicate heart problems, along with pale areas caused by anemia.

An examination of the fingers and toes is another part of a cardiovascular examination. Doctors look for clubbing, defined as thickness at the fingertips. Your toenails and fingernails will be viewed for signs of bleeding under the nail bed. Tender fingertips could mean that there is a heart problem, along with curvature of the fingers.

A critical step in the evaluation includes checking the patient’s pulse. The carotid artery in the neck usually provides a good measure of blood flow volume and velocity. A patient is positioned at a 45-degree angle for this portion of the test with their arm raised above their head.

Blood pressure readings help doctors diagnose high blood pressure, one of the risk factors for cardiovascular disease. This condition may be present without the patient’s knowledge because there are few warning signs. A doctor might take more than one blood pressure reading and test both arms.

Jugular vein pressure could reveal heart conditions affecting the right side of the heart. If the pressure is too low, it could indicate a blockage restricting blood flow. This test is typically followed by palpation of the chest area near the breastbone. A doctor commonly uses his or her hand on the chest cavity to feel vibrations or irregularities in the number of beats.
All four heart chambers can be listened to through a stethoscope. Doctors listen for abnormal echoes in the heart and aorta. Sounds that appear too loud or too soft could indicate problems with the valve’s operation.
Heart murmurs are measured by length and tone. The patient may be asked to breathe in and out as the doctor listens to the heart. Typically, the lungs are also examined through the stethoscope during this portion of the cardiovascular exam.

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