In medicine, the cardiac examination, also precordial exam, is performed as part of a physical examination, or when a patient presents with chest pain suggestive of a cardiovascular pathology. It would typically be modified depending on the indication and integrated with other examinations especially the respiratory examination. Like all medical examinations, the cardiac examination follows the standard structure of inspection, palpation and auscultation. The patient is positioned in the supine position tilted up at 45 degrees if the patient can tolerate this. The head should rest on a pillow and the arms by their sides. The level of the jugular venous pressure (JVP) should only be commented on in this position as flatter or steeper angles lead to artificially elevated or reduced level respectively. Also, left ventricular failure leads to pulmonary edema which increases and may impede breathing if the patient is laid flat. Lighting should be adjusted so that it is not obscured by the examiner who will approach from the right hand side of the patient as is medical custom. The torso and neck should be fully exposed and access should be available to the legs. General Inspection: Inspect the patient status whether he or she is comfortable at rest or obviously short of breath. Inspect the neck for increased jugular venous pressure (JVP) or abnormal waves. Any abnormal movements such as head bobbing. There are specific signs associated with cardiac illness and abnormality however, during inspection any noticed cutaneous sign should be noted. Inspect the hands for: Temperature – described as warm or cool, clammy or dry Skin turgor for hydration Janeway lesion Osler's node At the nails Splinter hemorrhage and Quincke's pulsation should be looked for as well as any deformity of the nail such as Beau's lines, clubbing or peripheral cyanosis. Inspect the head for: Cheeks for the malar flush of mitral stenosis. The eyes for corneal arcus and surrounding tissue for xanthalasma. Conjunctiva pallor a sign of anemia. The mouth for hygiene.

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Concepts associés (8)
Insuffisance mitrale
L'insuffisance mitrale (ou fuite mitrale ou régurgitation mitrale) est une des maladies les plus fréquentes parmi les pathologies des valves cardiaques chez l'Humain et quelques autres espèces animales. Il s'agit d'une dysfonction de la valve mitrale consistant en un défaut de coaptation des deux feuillets de cette dernière, entraînant un reflux de sang du ventricule gauche dans l'atrium gauche pendant la phase d'expulsion du sang (systole) (voir schéma), au lieu d'aller dans l'aorte.
Heart sounds
Heart sounds are the noises generated by the beating heart and the resultant flow of blood through it. Specifically, the sounds reflect the turbulence created when the heart valves snap shut. In cardiac auscultation, an examiner may use a stethoscope to listen for these unique and distinct sounds that provide important auditory data regarding the condition of the heart. In healthy adults, there are two normal heart sounds, often described as a lub and a dub that occur in sequence with each heartbeat.
Rétrécissement mitral
Le rétrécissement mitral (ou sténose mitrale) est une maladie de l'appareil circulatoire caractérisée par un obstacle à l'écoulement du sang à travers la valve mitrale pendant la diastole, dû à l'épaississement du tissu valvulaire. Il peut être associé à une insuffisance mitrale. On parle alors de « maladie mitrale ». Il s'agit essentiellement d'une complication tardive d'un rhumatisme articulaire aigu : une angine à streptocoque β-hémolytique du groupe A, non traitée correctement, se complique d'une cardite donnant, à long terme, une fibrose de la valve mitrale avec épaississement de cette dernière et fusion des commissures.
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