Cardiovascular assessment

Look

• Examine extremities for colour and perfusion.
• Compare upper and lower limbs.
• Look at the overall appearance of the patient, e.g. shortness of breath or pain.
• Jugular vein distention (JVD) provides an indication of the function of the right side of the heart:
• Look at the veins on the right side of the patient's neck, with the patient sitting at a 45° angle.
• If the jugular vein is distended or pulsing, it can indicate fluid overload, heart failure, constrictive pericarditis, cardiac tamponade or superior vena cava obstruction.
• Assessing JVD in small children may not be possible.

Listen

• Auscultate the apex beat.
• Compare the apex beat to the peripheral pulses. They should be similar.
• Auscultate across all four heart valves.
• Listen for arrhythmias and murmurs.

Feel

• Measure capillary refill time and heart rate, including rate, rhythm, volume and blood pressure.
• Palpate peripheral and central pulses.
• Assess for oedema, palpate lower limbs looking for peripheral oedema.