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Cardiovascular System – Physical Examination (Normal Findings)

Physical Examination (Long Format)
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📝 Cardiovascular History – Key Questions

👀 Inspection: Neck & Precordium

  • Neck: No jugular vein distention (JVD) or abnormal venous pulsations.
  • Precordium/Chest: Symmetric; skin color consistent with ethnicity; no scars or lesions.
  • No abnormal heaves, lifts, or visible pulsations.
  • No abnormal chest deformities;

💅 Palpation: Skin & Nails

Skin: Smooth, Warm, dry, intact; color appropriate for ethnicity.

  • Normal texture, thickness, mobility, and turgor (no tenting).
  • No lesions, scars, masses, or abnormal pigmentation patterns.

Nails: clean, smooth, and firmly attached

  • Nail beds pink, with normal shape.
  • No clubbing, cyanosis, deformities, or lesions.
  • Capillary refill < 2 seconds bilaterally.

✋ Palpation: Neck & Precordium

  1. Carotid Arteries: Pulse is present, 2+ normal amplitude, regular rhythm, no thrills.
  2. No precordial thrills, pulsations.
  3. Precordial Landmarks Palpated:
    • Aortic (2nd right ICS, RSB)
    • Pulmonic (2nd left ICS, LSB)
    • Erb’s point (3rd left ICS, LSB)
    • Tricuspid (4th–5th left ICS, LSB)
    • Mitral (5th ICS, left MCL, apex)

      • → No abnormal pulsations, thrills, or lifts detected.

  4. PMI (Point of Maximum Impulse): Palpated at 5th ICS, left MCL.

ICS = intercostal Space

MCL = Mid Clavicular line

🎧 Auscultation: Heart Sounds

  • S1 and S2: Normal in intensity, regular rate and rhythm.
  • S1 best heard at apex; S2 best at base.
  • Carotid pulse palpated to correlate S1 with systole.
  • No extra sounds present. (S3, S4)
  • No murmurs or abnormal heart sounds.