Physical Examination of the Heart

Introduction

The physical examination of the heart is a crucial part of diagnosing cardiovascular conditions. It involves a systematic assessment using inspection, palpation, and auscultation to detect abnormalities in heart function and structure.


Steps of the Cardiac Examination

1. Inspection

  • Observing the chest for any visible pulsations, asymmetry, or deformities.
  • Looking for signs of cyanosis (bluish skin) or edema (swelling), which may indicate heart failure.

2. Palpation

  • Feeling for the apical impulse (left ventricle's contraction, best felt at the 5th intercostal space, midclavicular line).
  • Checking for thrills (palpable murmurs) and heaves (forceful heart movements suggesting hypertrophy).

3. Auscultation

  • Using a stethoscope to listen to heart sounds in 5 main auscultation areas:
    1. Aortic valve – Right 2nd intercostal space
    2. Pulmonary valve – Left 2nd intercostal space
    3. Tricuspid valve – Lower left sternal border
    4. Mitral valve – Left 5th intercostal space (apex of the heart)
    5. Erb’s point – Left 3rd intercostal space (best for hearing certain murmurs)
  • Identifying heart sounds:
    • Normal sounds: S1 (closure of mitral & tricuspid valves), S2 (closure of aortic & pulmonary valves)
    • Abnormal sounds: Murmurs, gallops (S3, S4), rubs (pericarditis)

Clinical Significance

A thorough heart exam can help detect conditions such as: - Valvular heart disease (e.g., stenosis, regurgitation) - Heart failure - Pericarditis (inflammation of the pericardium) - Congenital heart defects

Regular physical exams are essential for early diagnosis and preventing complications.

Source recommendations

1. American Heart Association Guidelines for Cardiovascular Examination

  1. https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/heart-health-screenings
  2. https://professional.heart.org/en/guidelines-and-statements/prevent-calculator
  3. https://www.heart.org/en/health-topics/heart-failure/diagnosing-heart-failure/common-tests-for-heart-failure
  4. https://professional.heart.org/en/guidelines-and-statements
  5. https://atlas.heart.org/

2. European Society of Cardiology Guidelines on Cardiovascular Examination

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/ESC-Guidelines-on-non-cardiac-surgery-cardiovascular-assessment-and-managem
  2. https://academic.oup.com/eurheartj/article/43/39/3826/6675076
  3. https://pubmed.ncbi.nlm.nih.gov/36017553/
  4. https://academic.oup.com/eurheartj/article/35/35/2383/425095
  5. https://pubmed.ncbi.nlm.nih.gov/25086026/

Our advantages:

patient2376100
Best practices from USA, EU and Japan
Our answers to your questions are based on the clinical recommendations of countries with the most developed healthcare systems in the field of cardiology in the USA, the EU and Japan.
prescription18648039
Always up-to-date information
On a daily basis, we monitor for you all new scientific research publications in leading scientific journals on medical issues of interest to you.
We monitor all innovations and changes in the field of cardiac disease treatment on a daily basis.
fvfflf7q
Get second opinion
Here you can learn everything that even your doctor may not know about cardiology (if he does not speak English and he does not read 117 leading medical journals on cardiology every month).
1xr4duup
The most comprehensive and up-to-date collection of free cardiology materials
Our website contains the most comprehensive and up-to-date collection of free cardiology materials in your country.
Every 3-5 years, half of the scientific approaches to treatment in the field of cardiology are reviewed as a result of specialized scientific discoveries. With us, you don't have to wait these years to learn about the best ways to treat you and your loved ones.
arrow
Please register in order to receive information regarding possible complications and new approaches to treatment of cardiovascular diseases via email in our Newsletters.
arrow