A cardiovascular examination typically involves five physical observations. They include: a visual examination of the face, neck, and hands; testing pulses of the jugular vein; examination of large arteries; manual palpation; and listening to the heart with a stethoscope. A doctor looks for any abnormalities at each step of the cardiovascular examination that might indicate heart disease.
Patients typically undergo a cardiovascular examination after experiencing chest pain or shortness of breath. Doctors visually look for flushing in the face, sweating, and signs of jaundice. Jaundice might be indicated by yellowing in the eyes, especially under the upper eyelids. Rings in the cornea might also indicate heart problems, along with pale areas caused by anemia.
An examination of fingers and toes represents another part of a cardiovascular examination. The doctor looks for clubbing, defined as thickness at the tips of digits. Toenails and fingernails will be viewed to detect signs of bleeding under nail beds. Tender fingertips might mean a heart problem exists, along with curvature of the fingers.
A basic step in the evaluation includes checking the patient’s pulse. The carotid artery in the neck usually provides a good measurement of the volume and rate of blood flow. A patient is placed at a 45-degree angle for this part of the test with the arm raised above the head.
Blood pressure readings help doctors diagnose hypertension, one of the risk factors for cardiovascular disease. This condition might be present without the patient’s knowledge because there are few warning signs. A doctor might take more than one blood pressure reading and perform the exam on both arms.
Jugular vein pressure might reveal heart conditions affecting the right side of the heart. If pressure registers too low, it might indicate a blockage restricting blood flow. This test is typically followed by palpations of the chest area near the sternum. 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 heard via a stethoscope. Doctors listen for abnormal echoes in the heart and aorta. Sounds that appear too loud or too faint might indicate problems in valve function.
Heart murmurs are measured by length and pitch. The patient might be asked to breathe in and out as the doctor listens the heart. Typically, the lungs are also examined through the stethoscope during this part of the cardiovascular examination.