Table 2.

Cardiac examination

Inspection
Look at the participant	Comfortable at rest, cyanosis, breathless, scars, syndromes (eg, Marfan's, Down's, Turner's)
Look at the hands	Clubbing, peripheral cyanosis
Feel the radial pulse	Assess rate (over 15 s) and rhythm (sinus, regularly irregular or irregularly irregular)
Palpation
Feel for the apex beat	Usually in the 5th intercostal space in the midclavicular line.
Auscultation
Simultaneously listen and palpate a pulse (preferably a central pulse) to time any murmur to the cardiac cycle
Listen over the apex beat (mitral area) with the bell, and then the diaphragm	Listen for heart sounds 1 and 2 (and 3 and 4), systolic and diastolic murmurs
Listen over the left sternal edge in the 4th intercostal space (tricuspid area)	Listen for heart sounds 1 and 2, systolic and diastolic murmurs
Listen over the left sternal edge in the 2nd intercostal space (pulmonary area)	Listen for heart sounds 1 and 2, systolic and diastolic murmurs
Listen over the right sternal edge in the 2nd intercostal space	Listen for heart sounds 1 and 2, systolic and diastolic murmurs
Measure blood pressure

A brief cardiac examination will be conducted to include.