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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