How to Master the Cardiovascular Exam 🩺 | Physical Examination

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► This video dives deep into the cardiovascular exam and offers essential strategies to help you assess the heart like a pro. From understanding heart sounds to evaluating the sequence of valve closures, this video equips you with the skills to conduct a thorough cardiac assessment. You'll learn how to systematically listen for S1 and S2 heart sounds (the classic "lub-dub"), as well as additional sounds like S3 and S4 gallops, which indicate important cardiac conditions.

We break down the cardiovascular exam with a memorable acronym: MTAP (Mitral, Tricuspid, Aortic, Pulmonic), helping you remember the sequence of valve closures and their locations. This video emphasizes the importance of auscultation technique—starting with the heart sounds, then systole, and finally diastole—to ensure you don't miss any crucial murmurs.

You'll also discover how to distinguish between normal and abnormal heart sounds, understand physiologic splitting during respiration, and detect paradoxic splitting in patients with conditions like left bundle branch block. Additionally, this video explains how to use your stethoscope properly, including when to use the bell versus the diaphragm to catch both high and low-pitch sounds.

Finally, we guide you through the process of picking up subtle murmurs by positioning your patient optimally, such as in the left lateral decubitus position. By the end of this video, you'll have a complete toolkit for mastering the cardiovascular exam.

► CHAPTERS:
00:00 Intro and the "Many Things Are Possible" Acronym
01:09 Key Elements to Listen For During the Exam
02:44 Understanding Physiologic Splitting of S2
04:09 Paradoxical Splitting Explained
05:26 Stethoscope Use: Lower vs Higher Pitch Sounds
06:28 Practicing on the Patient
06:55 Recognizing Abnormal Heart Sounds: S4 Before Systole
08:14 Identifying S3 Heart Sounds Right After S2
09:27 Using the Left Lateral Decubitus Position for S3/S4
10:49 Conclusion and Final Thoughts

► THE PROF:
Stephen Holt attended Columbia University’s College of Physicians and Surgeons and subsequently completed his residency training and Chief Residency at Yale's Primary Care Internal Medicine Residency Program before joining the program as an Assistant Professor.

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