Cardiovascular Assessment Flashcards

A patient has bilateral pitting edema to the knees. Which combination of findings most strongly supports a cardiac rather than hepatic or renal cause?

Answer: Bilateral edema, raised JVP, bibasal lung crackles

Cardiac failure causes bilateral pitting edema, raised JVP (elevated central venous pressure), and pulmonary congestion producing bibasal crackles, distinguishing it from other causes.

On palpating the radial pulse, you note it is slow-rising and of low volume. This pulsus parvus et tardus is most consistent with which valvular lesion?

Answer: Aortic stenosis

Aortic stenosis produces a slow-rising, low-volume pulse (pulsus parvus et tardus) because obstruction to left ventricular outflow reduces the speed and volume of blood entering the aorta.

Quincke's sign — visible capillary pulsation at the nail bed when gentle pressure is applied — is most specifically associated with which condition?

Answer: Aortic regurgitation

Quincke's sign results from the widened pulse pressure in aortic regurgitation, producing exaggerated capillary pulsation visible even in peripheral capillaries.

The hepatojugular reflux test is performed by applying sustained pressure to the right upper quadrant. A positive result is defined as:

Answer: A sustained rise in JVP of ≥3 cm for ≥10 seconds

A positive hepatojugular reflux (sustained JVP rise ≥3 cm lasting ≥10 seconds) indicates the right heart cannot accommodate increased venous return, suggesting right or biventricular heart failure.

An ejection click heard in early systole at the aortic area is produced by which mechanism?

Answer: Turbulent flow through a stenotic but mobile aortic valve

An aortic ejection click occurs when a stenotic but still pliable aortic valve opens abruptly in early systole, producing a high-pitched click shortly after S1.

During inspection of the face in a cardiovascular OSCE, you observe a malar flush — bilateral rosy patches over the cheeks with central pallor. This is most associated with which valvular disease?

Answer: Mitral stenosis

Malar flush (mitral facies) is a classical peripheral sign of severe mitral stenosis, caused by reduced cardiac output and resulting cutaneous vasodilation and deoxygenation.

A fixed splitting of the second heart sound (S2) that does not vary with respiration is characteristic of which condition?

Answer: Atrial septal defect

Atrial septal defect causes fixed splitting of S2 because the left-to-right shunt equalizes right and left ventricular volumes throughout the respiratory cycle, keeping pulmonary valve closure persistently delayed.