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Cardio Exam
 
 

The Mouth

 
 
 
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Overview

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.

Dentition

  • 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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