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Cardio Exam

The Mouth

July 1st, 2020


In the context of the cardiovascular examination, inspecting the mouth can reveal information about the patient's dentition, reveal evidence of hypoxia or suggest the presence of a hereditary or congenital disorder.


  • Look For

  • Erythema, swelling or tenderness of the gingiva and discolouration or caries of the teeth.
  • Significance

  • Poor dentition is a nidus for infection that can spread systemically, most notably as a cause of infective endocarditis.
  • Poor oral health also increases the risk of fatal coronary events.
  • Gum disease is a sign of malnutrition.

Central Cyanosis

  • Interpretation

  • blue discolouration of the skin and mucous membranes.
  • Significance

  • Elevated levels of deoxygenated haemoglobin (hypoxaemia).
  • Causes of Central Cyanosis

  • High altitude
  • Obstructive lung disease, pulmonary oedema, pneumonia, pulmonary embolism
  • Congenital heart disease
  • Methaemoglobinaemia / sulfhaemoglobinaemia / carboxyhaemoglobinaemia

High-Arched Palate

  • Look For

  • Inspect and palpate the palate for elevation of the floor of the nasal fossa.
  • Causes of High-Arched Palate

  • Hereditary disorders - most commonly Marfan's syndrome.
  • Congenital defects
  • Note

  • Vitamin D deficiency causes a pseudo- high arch, due to hypoplasia of the alveolar and palatine processes.
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