心脏体格检查视诊英文版新.pptVIP

General Consideration During lifetime, the heart contracts more than 4 billion times. Pumping 200 million L blood to systemic circulation. Cardiac output varies under physiologic conditions from 3 to 30L/min. Heart rate varies from 60 to 150 beats/min. Physical Examination of Cardiovascular system In the present era of technological advances, particularly in the various imaging modalities, physical examination of the heart still provides useful information. Physical Examination of Cardiovascular system It is simple, convenient, cheap as premier assessment of the severity and an etiology of the lesions and also serves as an clue to use advanced techniques for the diagnosis of CVD. Routine and Techniques of PE of the Heart Patient’s exposure and position (sitting or lying down) , with enough light and appropriate temperature Four parts: inspection, palpation, percussion, and auscultation Inspection Precordium is the region of the anterior surface of the body covering the heart and lower thorax.  Contents of Inspection Thoracic cage deformity Apical impulse Abnormal pulsations in precordium Methods of Inspection Inspect the obverse side. Then obverse the patient’s lateral surface Thoracic Cage Deformity（ inspection） Asymmetry of the thoracic cage due to a convex bulging of the precordium suggests the presence of heart disease since childhood Thoracic Cage Deformity（ inspection） such as congenital heart disease and rheumatic heart disease, with skeletal molding to accommodate cardiac enlargement. Apical Impulse （ inspection） Apical impulse mainly results from the left ventricular contraction, when LV contracts, the apical knocks at the correspondent position of anterior chest wall, resulting in intercostal impulse outward movement. Apical Impulse （ inspection） Normal apical impulse Position: left border of sternum, fifth intercostal space, inside the midclavicular line 0.5~1.0cm Range: 2~2.5cm in diameter Apic