PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal &...
-
Upload
arlene-joseph -
Category
Documents
-
view
232 -
download
2
Transcript of PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal &...
![Page 1: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/1.jpg)
EXAMINATION OF CARDIOVASCULAR SYSTEM
PROF. DR. M. AKBAR CHAUDHRYMBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS
Principal & Professor of MedicineAzra Naheed Medical College Lahore
![Page 2: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/2.jpg)
MEDICINE IS TO BE LEARNED BY EXPERIENCE;
IT IS NOT AN INHERITANCE; IT CANNOT BE REVEALED. LEARN TO SEE, LEARN TO HEAR, LEARN TO FEEL, LEARN TO SMELL AND TO KNOW THAT BY PRACTICE ALONE YOU CAN BECOME EXPERT.
MEDICINE IS LEARNT BY THE BEDSIDE, AND NOT IN THE CLASSROOM. LET NOT YOUR CONCEPTIONS OF THE MANIFESTATIONS OF DISEASE COME FROM WORDS HEARD IN THE CLASSROOM OR READ IN A BOOK, SEE AND THEN REASON, AND COMPARE AND CONTROL. BUT SEE FIRST.
(SIR WILLIAM OSLER)
CARDIOVASCULAR SYSTEM
![Page 3: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/3.jpg)
MEDICAL PRACTICE IS NOT KNITTING AND WEAVING OR THE LABOUR OF HANDS, BUT IT MUST BE INSPIRED WITH SOUL AND FILLED WITH UNDER-STANDING AND EQUIPPED WITH THE GIFT OF KEEN OBSERVATION.
THE FACULTIES COMBINED WITH ACCURATE SCIENTIFIC KNOWLEDGE; ARE INDISPENSIBLE REQUISITES FOR PROFICIENT MEDICAL PRACTICE.
“MAIMORIDES”
![Page 4: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/4.jpg)
A GOOD PHYSICIAN:
“ALL OF HIM SEE’S ALL OF HIM LISTENS, AND ALL OF HIM THINKS.”
AND
“A CARDIOLOGIST LISTENS TWICE OVER, ONCE TO THE HISTORY AND AGAIN WITH PARTICULAR ATTENTION THROUGH THE STETHOSCOPE.”
![Page 5: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/5.jpg)
SYMPTOMS
1. DYSPNOEA (N.H.A.) (G1 – G4) - DYSPNOEA ON EFFORT
- DYSPNOEA AT REST- ORTHOPNOEA- PAROXYMAL NOCTURNAL DYSPNOEA (P.N.D)- CHEYNE – STOKE OR PERIODIC BREATHING
2. CHEST PAINA. ANGINA- SITE, RADIATION, CHARACTER, SEVERITY, DURATION, AGGRAVATING & RELIEVING FACTORS, ASSOCIATED PHENOMINA B. M. INFARCTIONC. PERICARDITISD. DISSECTING ANEURYSM OF AORTAE. PLEUREY PAINF. PUL. EMBOLISMG. FIBROSITIS, INTERCOSTAL MYALGIAH. MUSCULAR, EFFORT SYNDROME (ANXIETY)
HISTORY (ORIENTATED TO C.V.C)
![Page 6: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/6.jpg)
SYMPTOMS
3. PALPITATIONS4. COUGH5. HAEMOPTYSIS6. OEDEMA7. FATIGUE8. LOSS OF CONSCIOUSNESS (SYNCOPY)9. G.I / U.G. SYMPTOMS
HISTORY (ORIENTATED TO C.V.C)
![Page 7: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/7.jpg)
RHEUMATIC FEVER, CHOREADIPHTHERIAH/O DIABETES MELLITUSHYPERTENSIONSTONES, UTIOBSTETRIC HISTORY
- CIGARETTES- ALCOHAL
- DIET- JOB. STRESS
FAMILY HISTORY
OF RELATED DISEASES
PAST MEDICAL HISTORY
![Page 8: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/8.jpg)
GENERAL INSPECTION OF THE PATIENTPOSTURE, HYPERTHYROIDISM, HYPOTHROIDISM
GENERAL PHYSICAL EXAMINATION
OBSERVE THE PATIENT FROM THE END OF THE BED
WASH YOUR HANDS INTRODUCE YOURSELF TO THE PATIENT
![Page 9: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/9.jpg)
EXAMINATION OF HANDS (ANAEMIA)
GENERAL PHYSICAL EXAMINATION
![Page 10: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/10.jpg)
CYANOSIS a. CENTRALb. PERIPHRAL
GENERAL PHYSICAL EXAMINATION
![Page 11: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/11.jpg)
INSPECT THE EYES
GENERAL PHYSICAL EXAMINATION
![Page 12: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/12.jpg)
INSPECT THE MOUTH & TONGUE
GENERAL PHYSICAL EXAMINATION
![Page 13: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/13.jpg)
CLUBBING OF FINGERS
GENERAL PHYSICAL EXAMINATION
![Page 14: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/14.jpg)
OSLERS NODES
GENERAL PHYSICAL EXAMINATION
SPLINTER HAEMORRHAGES CAPILLARY PULSATION & DIGITAL THROBING
![Page 15: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/15.jpg)
PALMER ERYTHEMA
GENERAL PHYSICAL EXAMINATION
RHEUMATIC NODULES
SUPERA – TROCHLEAR L. NODES
![Page 16: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/16.jpg)
TAKE THE RADIAL PULSE
GENERAL PHYSICAL EXAMINATION
![Page 17: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/17.jpg)
1. RATE2. RHYTHM3. VOLUME4. CHARACTER5. PALPATION OF VESSEL WALL6. COMPARISON OF TWO RADIALS7. PALPATION OF RADIALS AND FEMORALS8. PALPATION OF ALL OTHER VESSELS9. COMPARISON OF RADIAL PULSE AND APEX BEAT (PULSUS
DEFICIT)10. TENSION…….??
PULSE EXAMINATION
![Page 18: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/18.jpg)
RATERANGE 60 - 100/minAVERAGE 72/minBELOW 60/min (BRADYCARDIA)ABOVE 100/min (TACHYCARDIA)RELATIVE BRADY CARDIA
RHYTHMREGULARIRREGULAR- REGULARLY IRREGULAR- IRREGULARLY IRREGULAR- REGULAR WITH OCCASIONAL IRREGULARITY
VOLUMESMALL VOLUMELARGE VOLUME
PULSE EXAMINATION
![Page 19: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/19.jpg)
NORMAL HYPERTENSION COLAPSING DICROTIC
BISFERIENS SMALL VOL. PLATEAU ANACROTIC
CHARACTER1. COLLAPSING / WATER HAMMER / CORRIGON2. PULSUS AL TERNANS3. PULSUS PARVUS4. BOUNDING PULSE5. PLATEAU PULSE, ANACROTIC PULSE6. PULSES PARADOXUS7. PULSES BIGEMINUS / TRIGEMINUS
PULSE EXAMINATION
![Page 20: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/20.jpg)
CHECK FOR A COLLAPSING PULSE
GENERAL PHYSICAL EXAMINATION
![Page 21: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/21.jpg)
DEPENDENT OEDEMA◦ ANKLES◦ FEET◦ LEGS◦ SACRUM
GENERAL PHYSICAL EXAMINATION
![Page 22: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/22.jpg)
GENERAL PHYSICAL EXAMINATION
THYROIDSWELLINGTREMORSSKINEYE BROWS
![Page 23: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/23.jpg)
![Page 24: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/24.jpg)
NECK VEINSENGORGEMENT, PALSATIONS
GENERAL PHYSICAL EXAMINATION
![Page 25: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/25.jpg)
Assess the Patient’s Jugular Venous Pressure
GENERAL PHYSICAL EXAMINATION
![Page 26: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/26.jpg)
ASSESSMENT FOR DISTENTION OF THE RIGHT INTERNAL JUGULAR (I.J) VEIN
![Page 27: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/27.jpg)
DETERMINING THE CVP(CENTRAL VENOUS PRESSURE)
GENERAL PHYSICAL EXAMINATION
![Page 28: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/28.jpg)
GENERAL PHYSICAL EXAMINATION
![Page 29: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/29.jpg)
BLOOD PRESSURE
GENERAL PHYSICAL EXAMINATION
![Page 30: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/30.jpg)
ARTHRITTIS, RH. CHOREA, NODULES, RASH
RESPIRATION
GENERAL PHYSICAL EXAMINATION
![Page 31: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/31.jpg)
GENERAL PHYSICAL EXAMINATION
ARCUS CORREALIS / SENALIS
![Page 32: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/32.jpg)
XANTHOMAS / XANTHELASMA
![Page 33: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/33.jpg)
A. INSPECTION1. SHAPE OF CHEST AND PRAECORDIUM2. NECK VEINS3. POSITION OF APEX BEAT4. VEINS – OF THE CHEST WALL5. OTHER PULSATIONS
- SUPRASTERNAL NOTCH- EPIGASTRIUM- RIGHT SECOND I.C.SPACE- LEFT SECOND I.C.SPACE
6. ANY SCAR, PIGMENTATION
EXAMINATION OF HEART
![Page 34: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/34.jpg)
B. PALPATION1. POSITION AND CHARACTER OF APEX BEAT2. THRILL3. HEAVE4. ANY OTHER PULSATIONS
EXAMINATION OF HEART
![Page 35: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/35.jpg)
PALPATION OF THE PRECORDIUM TO DETERMINE THE LOCATION OF THE PMI
![Page 36: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/36.jpg)
PALPATION OF THE PRECORDIUM TO DETERMINE THE LOCATION OF THE PMI
![Page 38: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/38.jpg)
PALPATE FOR ANY HEAVES OR THRILL
![Page 39: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/39.jpg)
C. PERCUSSION FOR CARDIAC DULLNESS1. HYPERTROPHY OF HEART2. DILATATION OF HEART3. PERICARDIAL EFFUSION4. AORTIC ANEURYSM5. VENT. ANEURYSM6. EMPHYSEMA
EXAMINATION OF HEART
![Page 40: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/40.jpg)
AUSCULTATION OF THE HEART
![Page 45: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/45.jpg)
AUSCULTATION OF THE HEART
![Page 46: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/46.jpg)
BAD EXAMINATION OPTIONS WHEN AUSCULTING MALE OR FEMALE PATIENTS
![Page 47: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/47.jpg)
AUSCULTTION OF HEART
![Page 48: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/48.jpg)
FURTHER CHECK FOR MITRAL STENOSIS
![Page 49: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/49.jpg)
ASSESS FOR AORTIC INCOMPETENCE
![Page 52: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/52.jpg)
AUSCULTATION
HEART SOUNDS1. INTENSITY OF HEART SOUNDS2. SPLITTING OF HEART SOUNDS
A) SPLITTING OF 1ST HEART SOUNDSB) SPLITTING OF 2ND H.S. (R.B.B.B., A.S.D., PUL. ST.)C) REVERSE SPLITTING OF 2ND HEART SOUNDS
(A.S., L.B.B.B., P.D.A., COARCTATION OF AORTA, H.O.C.M., L.V. DYSFUNCTION.)
EXAMINATION OF HEART
![Page 53: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/53.jpg)
EXAMINATION OF HEART
![Page 54: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/54.jpg)
AUSCULTATION3. TRIPLE RHYTHM (GALLOP RHYTHM)
a) III H.S. GALLOP (S3)b) IV H.S. GALLOP (S4)C) SUMMATION GALLOP
4. OPENING SNAP5. EJECTION CLICKS
EXAMINATION OF HEART
![Page 55: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/55.jpg)
1. MURMURS2. PERICARDIAL RUB3. CARDIO-RESPIRATORY MURMURS4. VENUS HUM
ADDITIONAL SOUNDS
![Page 56: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/56.jpg)
MURMURSORGANICBENIGN, INNOCENT, FUNCTIONALFEATURES
1. TIMING2. CHARACTER3. DISTRIBUTION4. RADIATION5. GRADING G1 G66. EFFECT OF RESP.7. EFFECT OF POSTURE8. EFFECT OF EXERCISE.
ADDITIONAL SOUNDS
![Page 57: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/57.jpg)
EXAMINATION OF HEART
![Page 58: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/58.jpg)
EXAMINATION OF HEART
![Page 59: PROF. DR. M. AKBAR CHAUDHRY MBBS(Pb), MRCP(UK), FRCP(E), FRCP(London), FACC(USA), FCPS Principal & Professor of Medicine Azra Naheed Medical College Lahore.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e3f5503460f94b2f238/html5/thumbnails/59.jpg)
THANK YOU
EXAMINATION OF CARDIOVASCULAR SYSTEM