Hyper dynamic apical impulse Seen in volume overload Seen as forceful and sustained beats in left ventricular diastolic overload Conditions associated Mitral regurgitation Aortic regurgitation VSD PDA Heaving apical impulse Seen as forceful and well sustained heave Generally seen in pressure overload of left ventricular Conditions associated Aortic stenosis Systemic hypertension Coarctation of aorta Obstructive cardiomyopathy Tapping […]

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Look around the room to see if any accessories/ instruments like wheelchairs/ inhalers/ Sputum sample Once the child is seated, ask if you could expose the upper body. For lower body, you may need to ask permission from the examiner also General examination Level of consciousness- Alert/ Oriented/ cooperative Decubitus (position in bed) Gait Built- […]

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General examination Level of consciousness- Alert/ Oriented/ cooperative Decubitus (position in bed) Gait Built- Average/ small or large for age Nutrition- Average/ undernutrition Any obvious dysmorphism Respiration effort- rate, rhythm, pattern, depth, laboured or not Face Dysmorphism Cyanosis/ Pallor Respiratory distress- nasal cannula/ nasal flaring Cardiovascular system examination involves 2 systems- peripheral and central cardiovascular […]

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Clubbing This is the swelling go the terminal part of fingers and toes It happens due to hypertrophy of the soft tissue in nail bed causing an increase in the anterior-posterior and transverse diameter of the nail Measurement It is measured by measuring the angle between the nail and nail bed ┬á– Its called the […]

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S3 and S4 is not generally heard. Occasionally it can happen in the following conditions Causes of S3 Left of right ventricular failure Chronic Myocardial infarction Hyperkinetic circulation like severe anemia, thyrotoxicosis Dilated cardiomyopathy Causes of S4 Ischaemic heart disease Aortic stenosis Systemic hypertension Hypertrophic cardiomyopathy

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Cyanosis can be seen in most examination cases. It is a grave mistake to miss such a finding. The advice below will help you answer questions. There are 2 types of cyanosis Peripheral cyanosis and central cyanosis Causes of peripheral cyanosis Exposure to cold Raynaud’s phenomenon Congestive cardiac failure Hyper viscosity syndrome Shock Causes of […]

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It is the development of pulmonary hypertension due to reversal of blood flow from right side of heart to left The common causes are Ventricular septal defect Patent ductus arteriosus Atrial septal defect Signs and symptoms Cyanosis Clubbing Polycythemia Signs of right ventricular hypertrophy Loud P2 Ejection click and ejection systolic murmur due to pulmonary […]

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Causes of Left ventricular failure Acute myocardial infarction Systemic hypertension Aortic regurgitation Aortic stenosis Mitral regurgitation Cardiomyopathy Coarctation of aorta Myocarditis Severe anemia Ventricular septal defect Causes of Right ventricular failure Chronic lung diseases Pulmonary stenosis Pulmonary hypertension Pulmonary thromboembolism Cardiomyopathy Myocarditis Causes of Left atrial failure Mitral stenosis Left atrial myxoma Mitral atresia Causes […]

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Decubitus If sitting up could mean orthopnoea Built Short stature in cyanotic heart disease Tall in Marfan’s syndrome Stunted in – Turner’s syndrome Nutrition Failure to thrive in chronic heart conditions Anaemia May be present in subacute bacterial endocarditis Cyanosis- can be seen in Congenital heart disease Acute pulmonary oedema Clubbing- could mean Congenital heart […]

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These murmurs are non-organic and are caused due to the flow rather than any anatomical damage to the heart These disappear with age Characteristics Usually systolic Never beyond grade 2 No thrill Best heard over pulmonary area No radiation Changes with opposition Otherwise normal heart sounds, normal chest X Ray and ECG Examples of innocent […]

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