Cardiovascular System Abnormal Findings I: Inspection and Palpation

Abnormal findings during the inspection and palpation of a cardiovascular examination include the following:

First, examine for signs of distress, such as shortness of breath.

Check for xanthelasma, a yellowish deposit on the eyelids associated with hyperlipidemia.

Look for cyanosis and clubbing of the nails, which suggest chronic hypoxia, and splinter hemorrhages, which are thin, red, or reddish-brown lines under the nails, suggesting infective endocarditis.

Then, check for jugular venous distention in a Semi-Fowler's position, a sign of increased right atrial pressure and heart failure.

In addition, inspect the legs for ulcers, varicose veins, and rubor, which indicate poor arterial perfusion.

Next, during palpation, assess the pulse for rate, rhythm, and strength.

Also, check for thready pulses, pulsus alternans, and pulse deficits.

Palpate the precordium at the left sternal edge for heaves and thrills. Locate the point of maximal impulse or PMI at the fifth intercostal space; a displaced PMI indicates cardiac enlargement.

Evaluate capillary refill and check for pitting edema in the lower extremities.