CVS examination...Forgotten art#KIP 1.Heaving apex....more than 2/3 of systole... Well sustained.... In stenotic lesions... 2.In stenotic lesions... mdm with opening snap 3.Hyperdynamic apex.... Definitely regurgitant lesions... 4.Dictums in cvs.... In aortic and pulmonary area only ejection systolic and early diastolic murmur are heard 5.In mitral and tricuspid area only PSM and mdm are heard... No other murmurs 6. For 1st heart sounds... Best is mitral and tricuspid area 7. For 2nd heart sounds... Best is pul(P2) and aor(A2) area and in these areas don't comment on 1st sound.. 8. Stills murmur is a normal murmur heard in thin individuals 9. APICAL IMPULSE Types... Right ventricular type in RVH and it cannot be felt properly... Indistinct apex... And in rvh u can get a pulsation in epigastric region Left ventricular apex.... Normally... Can be felt properly Hyperdynamic in regurgitant lesions... Lifts fing Heaving in stenotic.. Lifts and stays for 2/3 sys Tapping type...... 10. Percussion of heart... LHB,RHB AND 2nd space 11.In cardiac case in CVS examination start with peripheral vascular examination. 12.Do Traubes space percussion in any CVS case 13.In any CVS case where murmur is heard loudest that is the primary pathology and in other areas it is conducted... And timing of murmur Shud be same 14.Carditis..ull hear cooing type of murmur or seagull murmur 15. Example... Of above pearls... In ASD RIGHT VENTRICULAR APEX EPIGASTRIC PULSATION 16.If tachycardia without fever and present in sleep also.... Called Undue tachycardia. 17. Only aortic murmurs can radiate to carotids.... But pulmonary murmurs cannot radiate..
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