How to Perform a Cardiovascular Physical Assessment

You can sometimes determine the state of an individual's heart by simply looking at him. For example, a person who is very ill will likely be sweating, be pale and possibly have blue-tinted lips or fingers or other extremities. Someone who has nonacute heart failure may display weakness, muscle atrophy, weight loss and significant loss of appetite. Redness around the cheeks; yellow lipid deposits around the eyes, palms or tendons; a ring around the cornea; and a displaced eyeball are all visible signs of heart problems.

Things You'll Need

  • Stethoscope
  • Automatic blood pressure cuff
  • Movable light source
Show More

Instructions

    • 1

      Ensure that the patient is undressed or in a gown and that the space where the assessment is taking place is quiet.

    • 2

      Take the patient's hand to check his pulse. According to the Office of Medical Informatics, you want to "compress the radial artery with your index and middle fingers." Take the pulse for 10 seconds and multiply by six. Is the pulse regular? If not, take it for 1 minute. Make a note of rate and rhythm.

    • 3

      Measure the patient's blood pressure using a blood pressure cuff. The arm should be level with the heart. Ensure that the patient is not talking during test. Record the result.

    • 4

      Check jugular venous pressure. Have the patient lay down, face up, with the head raised to a 30-degree angle. Use your movable light and search for rapid, double maybe triple waves with each heartbeat. Identify the highest point of pulsation, which should be no more than 4 cm in a healthy adult.

    • 5

      Palpate the patient. According to the National Center for Biotechnology Information, you want to "locate the apex beat--the furthest point laterally and inferior to where you can clearly feel the apex (usually the fifth intercostal space in the midclavicular line)." Record the location, size and quality of the beat.

    • 6

      Use your stethoscope to listen for abnormalities in the aortic and pulmonary areas. If you hear abnormalities, you should listen over the carotids. If you hear an abnormality at the apex, listen in the armpit. Always examine from the patient's right side.