NURS 6023 Cardiovascular & Peripheral Vascular
Easy Exam Study Guide
Focus: diseases, findings, diagnostic tests/interpretion, red flags, and exam pearls
Fast “Must Know” Snapshot
Topic High-yield meaning Remember this
Preload Volume/stretch at end of diastole. Hypervolemia and heart failure can increase it. Preload = volume. Think: how full is the
ventricle?
Afterload Pressure/resistance the ventricle must pump against. Increased with hypertension, vasoconstriction, Afterload = pressure. Think: how hard is it to eject
pulmonary hypertension. blood?
Cardiac output Volume pumped out of ventricle; affected by stroke volume and heart rate. CO = SV x HR
Blood pressure Depends on cardiac output and systemic vascular resistance. BP = CO x SVR
PMI Normally tapping at 5th ICS left MCL. Sustained/increased can suggest LVH; diffuse can suggest PMI >3 cm = concern for LVH.
dilated ventricle/HF.
JVP Estimates right atrial pressure. Normal is <8 cm H2O; elevated JVP suggests increased right-sided Elevated if >4 cm above sternal angle despite
pressure. positioning.
S3 Early diastolic, low-pitched sound from passive filling. Can be normal in children/young adults; after S3 = “Ken-tuc-ky” = 3 syllables.
40 suggests systolic dysfunction.
S4 Late diastolic sound right before S1 from atrial contraction against stiff ventricle. Suggests diastolic S4 = “Ten-nes-see” = 4 syllables. Not heard in AFib.
dysfunction.
Murmurs Caused by turbulent blood flow. Echo is the standard test to establish the cause. MR + AS are systolic. MS + AR are diastolic.
Physical Exam Findings That Point to Disease
Assessment finding What it may suggest Exam pearl
Pale skin/lips Anemia, poor perfusion, or systemic illness. General appearance gives early clues before
auscultation.
Cyanosis Hypoxia; central cyanosis may suggest impaired pulmonary function or cardiac Look at lips, skin, mucous membranes, and
shunting. nail beds.
Diaphoresis/restlessness/confusion May occur with ischemia, hypoxia, shock, or decreased perfusion. Do not ignore “looks sick” with chest pain.
Marfan-type body habitus Tall, slender, long arm span, chest wall deformity, striae; risk for aortic root Connective tissue disease can be
dilation. cardiovascular.
Petechiae, splinter hemorrhages, Janeway Infective endocarditis clues. Endocarditis can present as fever/chills/weight
lesions, Osler nodes, Roth spots loss or even stroke-like symptoms.
Visible or palpable heave/lift/thrill Abnormal ventricular movement or turbulence from valvular disease. Thrill = palpable murmur. Grade IV or higher
usually has a thrill.
Peripheral hair loss, shiny skin, cool extremity Peripheral arterial disease/arterial insufficiency. Compare both legs and pulses.
Edema Heart failure, venous disease, renal/liver disease, lymphatic disease, Press dependent area 2-3 seconds; grade
medication-related causes. pitting 1+ to 4+.
NURS 6023 CV/PV Exam Study Guide - easy review format
, Diagnostic Tests & Easy Interpretation
Test What it helps identify Interpretation cue
12-lead EKG Rhythm, conduction abnormalities, ischemic changes, MI patterns. AFib = irregularly irregular with no distinct P waves.
VT/bradyarrhythmias are rhythm emergencies when
symptomatic.
MI lead map Localizes possible infarct territory. Inferior: II, III, aVF. Lateral: I, aVL, V5, V6. Septal: V1-V2.
Anterior: V3-V4.
Echocardiogram Valves, EF, wall motion, valvular dysfunction, thoracic aorta. Echo is the standard test for murmur cause and evaluates
systolic/diastolic function.
Chest X-ray Cardiomegaly, vascular congestion, pleural effusion, pulmonary edema/CHF Abnormal CXR often leads to echo or other cardiac testing.
clues, calcification.
Troponin/cardiac biomarkers Myocardial injury in ACS; may also rise with demand ischemia. Positive troponin does not always mean plaque rupture; assess
the whole picture.
CBC/BMP/CMP Anemia, infection, electrolyte abnormalities, kidney function, CHF Electrolyte problems can trigger arrhythmias. Anemia can cause
contributors. demand ischemia.
Coronary/peripheral angiogram Stenosis or occlusion in coronary/peripheral arteries. Lecture pearl: angiogram is the definitive way to detect
blockages/stenosis.
Abdominal ultrasound AAA screening/evaluation. If AAA is detected, CTA may follow for better anatomic detail.
Venous ultrasound DVT evaluation; used before venous insufficiency reflux testing. DVT usually unilateral edema/pain/warmth, but PE may be the
first sign.
ABI Peripheral arterial disease screening/diagnosis. ABI is a gold standard screening test; arterial Doppler is more
definitive.
Carotid ultrasound Carotid artery stenosis. Gold standard in lecture. Abnormal results often followed by CTA
head/neck.
Heart Sounds, Auscultation, and Murmurs
Sound / murmur Where/when Meaning Remember
S1 Onset of systole; closure of mitral and tricuspid valves. Start of ventricular contraction. S1 = “lub” = AV valves
Loudest at apex/mitral area. Diaphragm. close.
S2 Beginning of diastole; closure of aortic and pulmonic Start of ventricular relaxation. S2 = “dub” = semilunar
valves. Best at base/aortic area. Diaphragm. valves close.
S3 Early diastole; low-pitched; apex; bell; left lateral. Normal in children/young adults; after age 40 suggests Ken-tuc-ky.
systolic dysfunction.
S4 Late diastole immediately before S1; apex/mitral; bell; left Diastolic dysfunction; HTN, CAD, pregnancy/high-output Ten-nes-see. Requires
lateral. states, recent MI, aortic stenosis. atrial contraction, so
absent in AFib.
Mitral regurgitation Holosystolic; best at apex to left sternal border; radiates to Backflow through closed mitral valve. MR = systolic.
midaxilla.
Aortic stenosis Midsystolic; best at 2nd ICS right sternal border; radiates to Narrowed aortic valve/outflow obstruction. AS = systolic. Think
carotids. “radiates to carotids.”
Mitral stenosis Early diastolic; best at mitral area; usually no radiation. Narrowed mitral valve opening. MS = diastolic.
Aortic regurgitation Early diastolic; best at aortic area/base; unchanged by Backflow through closed aortic valve. AR = diastolic.
respiration.
Murmur grade What it means
I Very faint, barely audible in quiet room.
NURS 6023 CV/PV Exam Study Guide - easy review format
Easy Exam Study Guide
Focus: diseases, findings, diagnostic tests/interpretion, red flags, and exam pearls
Fast “Must Know” Snapshot
Topic High-yield meaning Remember this
Preload Volume/stretch at end of diastole. Hypervolemia and heart failure can increase it. Preload = volume. Think: how full is the
ventricle?
Afterload Pressure/resistance the ventricle must pump against. Increased with hypertension, vasoconstriction, Afterload = pressure. Think: how hard is it to eject
pulmonary hypertension. blood?
Cardiac output Volume pumped out of ventricle; affected by stroke volume and heart rate. CO = SV x HR
Blood pressure Depends on cardiac output and systemic vascular resistance. BP = CO x SVR
PMI Normally tapping at 5th ICS left MCL. Sustained/increased can suggest LVH; diffuse can suggest PMI >3 cm = concern for LVH.
dilated ventricle/HF.
JVP Estimates right atrial pressure. Normal is <8 cm H2O; elevated JVP suggests increased right-sided Elevated if >4 cm above sternal angle despite
pressure. positioning.
S3 Early diastolic, low-pitched sound from passive filling. Can be normal in children/young adults; after S3 = “Ken-tuc-ky” = 3 syllables.
40 suggests systolic dysfunction.
S4 Late diastolic sound right before S1 from atrial contraction against stiff ventricle. Suggests diastolic S4 = “Ten-nes-see” = 4 syllables. Not heard in AFib.
dysfunction.
Murmurs Caused by turbulent blood flow. Echo is the standard test to establish the cause. MR + AS are systolic. MS + AR are diastolic.
Physical Exam Findings That Point to Disease
Assessment finding What it may suggest Exam pearl
Pale skin/lips Anemia, poor perfusion, or systemic illness. General appearance gives early clues before
auscultation.
Cyanosis Hypoxia; central cyanosis may suggest impaired pulmonary function or cardiac Look at lips, skin, mucous membranes, and
shunting. nail beds.
Diaphoresis/restlessness/confusion May occur with ischemia, hypoxia, shock, or decreased perfusion. Do not ignore “looks sick” with chest pain.
Marfan-type body habitus Tall, slender, long arm span, chest wall deformity, striae; risk for aortic root Connective tissue disease can be
dilation. cardiovascular.
Petechiae, splinter hemorrhages, Janeway Infective endocarditis clues. Endocarditis can present as fever/chills/weight
lesions, Osler nodes, Roth spots loss or even stroke-like symptoms.
Visible or palpable heave/lift/thrill Abnormal ventricular movement or turbulence from valvular disease. Thrill = palpable murmur. Grade IV or higher
usually has a thrill.
Peripheral hair loss, shiny skin, cool extremity Peripheral arterial disease/arterial insufficiency. Compare both legs and pulses.
Edema Heart failure, venous disease, renal/liver disease, lymphatic disease, Press dependent area 2-3 seconds; grade
medication-related causes. pitting 1+ to 4+.
NURS 6023 CV/PV Exam Study Guide - easy review format
, Diagnostic Tests & Easy Interpretation
Test What it helps identify Interpretation cue
12-lead EKG Rhythm, conduction abnormalities, ischemic changes, MI patterns. AFib = irregularly irregular with no distinct P waves.
VT/bradyarrhythmias are rhythm emergencies when
symptomatic.
MI lead map Localizes possible infarct territory. Inferior: II, III, aVF. Lateral: I, aVL, V5, V6. Septal: V1-V2.
Anterior: V3-V4.
Echocardiogram Valves, EF, wall motion, valvular dysfunction, thoracic aorta. Echo is the standard test for murmur cause and evaluates
systolic/diastolic function.
Chest X-ray Cardiomegaly, vascular congestion, pleural effusion, pulmonary edema/CHF Abnormal CXR often leads to echo or other cardiac testing.
clues, calcification.
Troponin/cardiac biomarkers Myocardial injury in ACS; may also rise with demand ischemia. Positive troponin does not always mean plaque rupture; assess
the whole picture.
CBC/BMP/CMP Anemia, infection, electrolyte abnormalities, kidney function, CHF Electrolyte problems can trigger arrhythmias. Anemia can cause
contributors. demand ischemia.
Coronary/peripheral angiogram Stenosis or occlusion in coronary/peripheral arteries. Lecture pearl: angiogram is the definitive way to detect
blockages/stenosis.
Abdominal ultrasound AAA screening/evaluation. If AAA is detected, CTA may follow for better anatomic detail.
Venous ultrasound DVT evaluation; used before venous insufficiency reflux testing. DVT usually unilateral edema/pain/warmth, but PE may be the
first sign.
ABI Peripheral arterial disease screening/diagnosis. ABI is a gold standard screening test; arterial Doppler is more
definitive.
Carotid ultrasound Carotid artery stenosis. Gold standard in lecture. Abnormal results often followed by CTA
head/neck.
Heart Sounds, Auscultation, and Murmurs
Sound / murmur Where/when Meaning Remember
S1 Onset of systole; closure of mitral and tricuspid valves. Start of ventricular contraction. S1 = “lub” = AV valves
Loudest at apex/mitral area. Diaphragm. close.
S2 Beginning of diastole; closure of aortic and pulmonic Start of ventricular relaxation. S2 = “dub” = semilunar
valves. Best at base/aortic area. Diaphragm. valves close.
S3 Early diastole; low-pitched; apex; bell; left lateral. Normal in children/young adults; after age 40 suggests Ken-tuc-ky.
systolic dysfunction.
S4 Late diastole immediately before S1; apex/mitral; bell; left Diastolic dysfunction; HTN, CAD, pregnancy/high-output Ten-nes-see. Requires
lateral. states, recent MI, aortic stenosis. atrial contraction, so
absent in AFib.
Mitral regurgitation Holosystolic; best at apex to left sternal border; radiates to Backflow through closed mitral valve. MR = systolic.
midaxilla.
Aortic stenosis Midsystolic; best at 2nd ICS right sternal border; radiates to Narrowed aortic valve/outflow obstruction. AS = systolic. Think
carotids. “radiates to carotids.”
Mitral stenosis Early diastolic; best at mitral area; usually no radiation. Narrowed mitral valve opening. MS = diastolic.
Aortic regurgitation Early diastolic; best at aortic area/base; unchanged by Backflow through closed aortic valve. AR = diastolic.
respiration.
Murmur grade What it means
I Very faint, barely audible in quiet room.
NURS 6023 CV/PV Exam Study Guide - easy review format
