Cardiovascular Assessment Flashcards

During a cardiovascular OSCE station, where is the mitral valve best auscultated?

Answer: 5th intercostal space, midclavicular line

The mitral valve is best heard at the cardiac apex, located at the 5th intercostal space in the midclavicular line, where the left ventricle is closest to the chest wall.

A third heart sound (S3) auscultated in a 58-year-old patient is most likely indicative of which condition?

Answer: Heart failure with ventricular dilation

In adults over 40, an S3 (ventricular gallop) is pathological and most commonly indicates heart failure, reflecting rapid ventricular filling in a dilated, poorly compliant ventricle.

During JVP assessment, which waveform is characteristically absent in atrial fibrillation?

Answer: a wave

The 'a' wave represents atrial contraction; in atrial fibrillation there is no organized atrial contraction, so the 'a' wave is absent from the JVP waveform.

A collapsing (water-hammer) pulse on cardiovascular examination is most characteristic of which valvular pathology?

Answer: Aortic regurgitation

A collapsing pulse results from a wide pulse pressure caused by backflow of blood into the left ventricle during diastole in aortic regurgitation, producing a rapid rise and fall.

Which location is correct for auscultating the aortic valve during a cardiovascular OSCE examination?

Answer: 2nd intercostal space, right sternal edge

The aortic valve is best auscultated at the 2nd intercostal space, right sternal edge (right upper sternal border), where aortic sounds are transmitted.

During peripheral examination for cardiovascular disease, splinter hemorrhages under the fingernails are most strongly associated with which condition?

Answer: Infective endocarditis

Splinter hemorrhages (longitudinal dark streaks under the nail) are peripheral stigmata of infective endocarditis, caused by microemboli lodging in subungual capillaries.

You find a displaced apex beat at the 6th intercostal space, anterior axillary line. What does this most likely indicate?

Answer: Left ventricular enlargement

A laterally and inferiorly displaced apex beat indicates left ventricular enlargement, as the enlarged left ventricle pushes the apex further outward and downward.