Cardiovascular Assessment: Heart Sounds, Pulses, and Blood Flow

Angina (pectoris)

Chest pain caused by reduced blood flow to the heart muscle (myocardial ischemia).

Ankle/brachial index

A comparison of ankle to arm blood pressure; used to assess peripheral arterial disease.

Aortic valve

Semilunar valve between the left ventricle and aorta; prevents backflow into the ventricle.

Apical

Refers to the apex of the heart; apical pulse is taken at the 5th intercostal space, midclavicular line.

Arteries

Blood vessels that carry oxygenated blood away from the heart.

Amplitude (of pulse)

Strength or fullness of the pulse; described as bounding, normal, weak, or absent.

Atrioventricular valve (AV-valve)

Valves between the atria and ventricles (tricuspid on right, mitral on left).

Brachial

Pulse felt in the upper arm; used for blood pressure measurement.

Bruit

A blowing or swishing sound heard over an artery, indicating turbulent blood flow.

Capillary refill

Time for color to return to nail bed after blanching; normal is less than 2 seconds.

Clubbing

Enlargement of fingertips and curved nails due to chronic hypoxia.

Carotid pulse

Pulse felt on either side of the neck; reflects heart activity.

Contour

The shape or outline of the pulse wave; normally smooth and rounded.

Diastolic

Pressure in the arteries when the heart relaxes between beats.

Dorsalis pedis pulse

Pulse located on the top of the foot; assesses peripheral circulation.

Edema

Swelling caused by excess fluid in body tissues.

Electrocardiogram (ECG)

Recording of the electrical activity of the heart.

Erb's point

Cardiac auscultation area at the 3rd intercostal space, left sternal border; where S1 and S2 are best heard equally.

Intercostal space (ICS)

The space between two ribs; used as a landmark for heart and lung assessments.

Jugular vein

Vein in the neck that reflects right atrial pressure and venous return.

Left sternal border (LSB)

Area along the left edge of the sternum used for heart auscultation.

Mitral valve

AV valve between the left atrium and left ventricle; also called bicuspid valve.

Murmur

Abnormal heart sound caused by turbulent blood flow through valves or chambers.

Orthostatic

Relating to posture changes; orthostatic vitals assess for blood pressure changes with position.

Pallor

Paleness of the skin due to decreased blood flow or hemoglobin.

Perfusion

The flow of oxygenated blood through body tissues.

Popliteal pulse

Pulse felt behind the knee; assesses blood flow to the lower leg.

Posterior tibial pulse

Pulse felt behind the medial ankle; assesses circulation to the foot.

Pulmonic valve

Semilunar valve between the right ventricle and pulmonary artery.

Pulse deficit

Difference between apical and radial pulse rates; indicates weak heart contractions.

Pulses

Rhythmic throbbing of arteries as blood is propelled through them.

Pulsation

A palpable beat resulting from blood flow through a vessel.

Radial pulse

Pulse felt at the wrist; most common for assessing heart rate.

Heart rate

Number of heartbeats per minute.

Heart rhythm

Pattern of the heartbeats; may be regular or irregular.

Right sternal border (RSB)

Area along the right edge of the sternum used for heart auscultation.

S1, S2, S3, S4

Normal and extra heart sounds; S1/S2 are normal, S3/S4 may indicate heart failure or stiffness.

Semilunar valves

Aortic and pulmonic valves; control blood flow out of the ventricles.

Systolic

Pressure in arteries when the heart contracts.

Temporal pulse

Pulse located on the temple; used to assess circulation to the head.

Thrill

A palpable vibration felt over the heart or artery indicating turbulent blood flow.

Tricuspid valve

AV valve between the right atrium and right ventricle.

Ulnar pulse

Pulse located on the ulnar side of the wrist (pinky side); used if radial pulse is difficult to feel.

Veins

Blood vessels that carry deoxygenated blood back to the heart.