Cardiovascular Examination for OSCEs
In examination of any system there are 2 important points
to remember. They are:
1)
Correct method
2)
Practice
Method
The method used by the most senior clinicians and the
most junior medical students is one and the same. The difference is that the
senior clinician has practiced it innumerable times and hence is far better at
it.
Learn the method of cardiovascular examination. Read
ACES for PACES chapter 10, then practice
on patients, read again and refine your method. Repeat ad infinitum
Ask a colleague to observe you and see if you are going
through every step
Use the summary in the
appendix of ACES for PACES as a checklist to make sure you are
going through every step
Diagnosis
After you are confident that your method is satisfactory,
think of making a diagnosis
Read the preface of ACES for
PACES and learn the hypothetico deductive method of making a
diagnosis.
Study the common lesions of the cardiovascular system (ACES
for PACES pages 171-174)
Study the symptoms and signs that may occur in relation
to cardiovascular disease and the causes of these clinical features (ACES
for PACES pages 174-225)
Points to Remember
Marks are awarded for each step of the examination.
Hence it is essential to have a good method and go
through every step of it
Cardiovascular lesions are not diagnosed on auscultation
The signs that one elicits in other parts of the
examination are often much more useful in determining the lesion present
Examples of this are:
A small volume slow rising pulse giving a clue to the
presence of aortic stenosis
A collapsing pulse suggesting aortic regurgitation
For examples of analysis of cases using the advanced
clinical evaluation system (ACES) see the examples on this website and the
cases analysed in the blog clinical-skills.blogspot.com
