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Right Atrium
Right Ventricle
Left Ventricle
Left Atrium
Pulmonary Artery
Pulmonary Vein
Aorta
TWO PUMPS
Subjective data:
1. Assessment of chief complaints:
Chest pain: location, quality, duration & associated symptoms.
Irregular heart beat: too fast, jump etc.
2. Assessment of risk factors:
4
Ask about history of hypertension, diabetes, and rheumatic fever
Ask about family history of heart attack, hypertension, stroke, and diabetes
How many hours a day do you work? How do cope with stress.
Pain in calves, feet, buttocks or legs? What aggravates the pain (walking, sitting long periods, standing
long periods, sleep) what relieves the pain “elevating legs, rest, lying down”.
Detect abnormalities in site of palpation and abnormal sounds especially for thrill
“abnormal flow of blood”
Palpation of pulse at base of the heart (putting your hand at second left
intercostal spaces at sternal borders).
All heart sounds are generally low pitched “low frequency” and difficult for the human ear to hear.
Auscultation can be started from base to apex or from apex to the base.
Assess:
Concentrates initially on sound "1", noting its intensity and variations, possible duplication and effects of respiration.
Sound "2": results from closing of the aortic & pulmonary valves
Diastole begins with Sound "2" and extends to next Sound "1"
Sound "2" louder than Sound "1" at the base of heart, and is lighter than Sound "1" at the apex.
Finally listen for extra sounds and for murmurs
Sound "3": During diastole, rapid filling and distention of ventricles occur
causes vibrations of ventricular walls" and this known as sound "3" ". Sound
"3" best heard at the apex with bell of stethoscope. Its indicate Pathological
alterations in ventricular filling in early diastole. it represents a normal finding
in children
Sound "4": occur after Sound "3" (late diastolic filling), occur from vibrations
of ventricular wall or vibrations of the valves. It’s usually associated with
cardiac disease, often that with altered ventricular compliance