PEMERIKSAAN FISIK SISTEM KARDIOVASKULER Oleh: Ns. Turiman, S.Kep{ Mahasiswa MIK Peminatan KMB 2020 )

Summary

In this educational video, a master's student in nursing demonstrates the process of conducting a thorough cardiovascular physical examination. The script covers all stages, including anamnesis, inspection, palpation, percussion, and auscultation. Key aspects such as assessing symptoms like chest pain, examining vital signs, checking for heart murmurs, and testing pulses are explored in detail. The script emphasizes the importance of systematic examination, using various techniques to detect heart conditions. It concludes with documentation, providing a comprehensive guide for healthcare practitioners to conduct an effective heart examination.

Takeaways

• 😀 Introduction: Turiman, a master's nursing student, presents a cardiovascular physical examination practice as a learning experience.
• 😀 Patient interview: The patient, Pak Asep, has a history of chest pain, shortness of breath, and family history of hypertension, with risk factors including smoking.
• 😀 Stage 1: Inspection begins with assessing the patient's face for signs of anemia, cyanosis, or shortness of breath, followed by examining the chest wall for abnormalities.
• 😀 Stage 2: Palpation of the chest wall helps identify abnormal pulsations, location of heart murmurs, and possible heart hypertrophy signs.
• 😀 Stage 3: Examination of extremities checks for symptoms such as cyanosis, edema, and abnormal finger appearance like clubbing, and checks capillary refill time (CRT).
• 😀 Jugular vein assessment: The height of the internal jugular vein (JVP) is measured, where a normal value is 5 cm, indicating proper venous pressure.
• 😀 Heart palpation: The examiner looks for abnormal heart lifts, and checks for pulses around the sternum and epigastric areas to assess possible heart enlargement or right ventricle hypertrophy.
• 😀 Cardiac percussion: Percussion determines the boundaries of the heart to detect any abnormal expansion or contraction, such as in cases of cardiomegaly.
• 😀 Auscultation: Heart sounds (S1, S2) are listened to in four key areas (aortic, pulmonary, tricuspid, and mitral valves) to assess for abnormalities like heart murmurs or extra heart sounds.
• 😀 Pericardial friction: The examiner listens for the sound of friction in the pericardial area, which might indicate pericarditis, a condition of the heart's lining.

Q & A

What is the primary goal of the cardiovascular physical examination in this script?

The primary goal of the cardiovascular physical examination is to assess the condition of the patient's heart and cardiovascular system, identifying any abnormalities such as heart murmurs, irregular heart sounds, and signs of cardiovascular diseases.

How does the script introduce the examination process for the cardiovascular system?

The script introduces the examination by beginning with a greeting and introduction by the student, Turiman, who mentions that the practice will focus on examining the cardiovascular system through inspection, palpation, percussion, and auscultation.

What specific symptoms does the patient report that are relevant to the cardiovascular examination?

The patient reports chest pain, described as stabbing pain on the left side, spreading to the left shoulder. The pain lasts about 15 minutes and is accompanied by cold sweats. The patient also has a history of smoking five packs of cigarettes daily.

What are the key steps involved in the cardiovascular physical examination as outlined in the script?

The key steps include anamnesis (patient history), inspection of the face, chest wall, and upper and lower extremities, palpation to check for abnormal pulsations, percussion to determine the heart's boundaries, and auscultation to listen for abnormal heart sounds or murmurs.

What is the significance of the Jugular Venous Pressure (JVP) measurement in this examination?

The JVP measurement helps assess the pressure in the internal jugular vein, which can indicate heart conditions such as right heart failure. A JVP of more than 5 cm is considered abnormal.

How does palpation help in diagnosing cardiovascular issues in this examination?

Palpation is used to assess the location and strength of the heart's lift or pulsation. Abnormal shifts, such as in left ventricular hypertrophy or right ventricular hypertrophy, can be detected through palpation.

What does a heart murmur during auscultation indicate?

A heart murmur indicates turbulent blood flow, which could result from valve dysfunction (e.g., aortic stenosis or mitral regurgitation). The murmur is categorized as systolic or diastolic, based on the phase of the heartbeat.

Why is the examination of the pericardial friction rub important?

The pericardial friction rub is important as it can indicate pericarditis, an inflammation of the pericardium, which produces a characteristic sound similar to sandpaper rubbing.

What are the expected normal findings in the cardiovascular physical examination?

Normal findings include symmetrical chest walls, no visible abnormal pulsations, regular heart sounds (S1 and S2), no heart murmurs, and a normal Jugular Venous Pressure (JVP) of around 5 cm.

How does smoking impact the cardiovascular examination findings in this patient?

The patient's heavy smoking history increases the risk of cardiovascular diseases, which may contribute to symptoms like chest pain, shortness of breath, and abnormal findings in the examination, such as signs of coronary artery disease or hypertension.