renifejn
Guru
I have a new Cardiologist and in leveling her exam with 95 and 97 guidelines I cant get past detailed. Am I missing something? What guidelines did you use?
The physical examination showed a well appearing and well nourished male iin no distress with no visible cyanosis. Examination of the head was unremarkable. The eyes were unremarkable. The ears were not assessed. The neck was unremarkable. Examination of the mouth and throat was remarkable for the cleft lip and palate. The thoracic cage was unremarkable. There was no prior surgical wound or incision. Palpation was deferred. The lung exam showed unlabored breathing with no retractions. Auscultation revealed good, equal breath sounds. Furthermore, the breath sounds were clear with no rales. Her cardiac exam showed a precordial impulse at the left chest. There was a normodynamic impulse. The pulses (carotid, radial, femoral and brachial) were normal with no exceptions. There was no right femoral -brachial delay. The heart rate was normal with a regular rhythm. The heart sounds showed a normal S1 with a normal S2. S2 was normally split. Manuevers were not performed. At most, a grade 1-2/6 nonspecific SEM was noted at the left sternal border while lying down. No clicks were noted. No rubs were noted. No additional sounds were noted. Abdominal exam revealed a soft and nondistended abdomen with no bruits. Ascites was not apparent. No tenderness was appreciated. Liver size was normal. A spleen was not palpable. No masses were noted. Extremity examination was normal without clubbing, edema and cyanosis. The neurologic examination showed no focal or gross deficits. There were no additional findings.
The physical examination showed a well appearing and well nourished male iin no distress with no visible cyanosis. Examination of the head was unremarkable. The eyes were unremarkable. The ears were not assessed. The neck was unremarkable. Examination of the mouth and throat was remarkable for the cleft lip and palate. The thoracic cage was unremarkable. There was no prior surgical wound or incision. Palpation was deferred. The lung exam showed unlabored breathing with no retractions. Auscultation revealed good, equal breath sounds. Furthermore, the breath sounds were clear with no rales. Her cardiac exam showed a precordial impulse at the left chest. There was a normodynamic impulse. The pulses (carotid, radial, femoral and brachial) were normal with no exceptions. There was no right femoral -brachial delay. The heart rate was normal with a regular rhythm. The heart sounds showed a normal S1 with a normal S2. S2 was normally split. Manuevers were not performed. At most, a grade 1-2/6 nonspecific SEM was noted at the left sternal border while lying down. No clicks were noted. No rubs were noted. No additional sounds were noted. Abdominal exam revealed a soft and nondistended abdomen with no bruits. Ascites was not apparent. No tenderness was appreciated. Liver size was normal. A spleen was not palpable. No masses were noted. Extremity examination was normal without clubbing, edema and cyanosis. The neurologic examination showed no focal or gross deficits. There were no additional findings.