CVS Examination in a 40 year old female with severe anemia

E-log containing History ,Clinical images , Investigations of the patient examined -

http://tulapavan.blogspot.com/2022/02/a-40-yr-old-female-with-severe-anaemia.html

Examination Findings - 

INSPECTION 

• Epigastric impulse was seen near the umblicus 
• Diffuse Pulsations of the apex beat between the 5th and 6th Intercoastal space
• Raised JVP 
• Pectus excavatum , Pectus carinatum absent 
• No scars

PALPATION 

Apex beat 

• Diffuse pulsation in 5th and 6th intercoastal space
• character- forceful 
• Parasternal heave - visible, palpable, not obliterable with pressure
• Thrills present  

AUSCULTATION 

• Loud S1 , S2 heard in aortic , pulmonary , mitral and tricuspid area.