This transcript details a medical consultation and physical examination performed by a cardiologist, Dr. Anna Valeryevna, on a 50-year-old patient named Nikolay Nikolaevich, who presented with chest pain and fainting spells.

Patient Intake and Consent
📌 The patient, Nikolay Nikolaevich, 50 years old, reported symptoms of chest pain and fainting episodes.
✍️ The physician obtained informed consent for the cardiovascular system examination after explaining the necessary procedures.
🧼 The doctor performed hand hygiene and donned gloves before proceeding with the physical examination.

Cardiovascular System Physical Examination
🌡️ Blood pressure was measured at 110/80 mmHg, with a pulse rate of 70 beats per minute and a respiratory rate of 16 per minute.
👀 Capillary refill test was negative, and the conjunctiva, oral mucosa, and neck veins appeared to be of normal color.
🧭 Peripheral pulses (carotid, brachial, radial, and femoral arteries) were assessed and found to be symmetric, with the radial pulse described as rhythmic, symmetric, with small volume, and non-tense.
🫁 Precordial palpation revealed the apex beat located 1–1.5 cm medial to the midclavicular line in the 5th intercostal space; no pulse deficit was noted.

Auscultation Findings
💔 Auscultation over the aortic valve revealed a diastolic-systolic murmur (described as a "crescendo systolic murmur" or "systolic murmur" heard over the aortic valve in a later step).
👂 A faint systolic murmur was heard over the mitral valve and also over the tricuspid valve.
📣 A systolic murmur with maximum intensity over the aortic valve was heard in all auscultation points when the patient was sitting and leaning slightly forward.
💨 Pulmonary auscultation was performed across the upper, lateral, and posterior sections of the lungs with the patient breathing normally; no specific pathological findings were noted in the lungs during the documented segment.

Key Points & Insights
➡️ A thorough physical examination protocol for a cardiology patient includes assessing skin color, capillary refill, mucous membranes, peripheral pulses, and performing detailed auscultation across all valve areas.
➡️ The presence of a systolic murmur heard maximally over the aortic valve upon sitting/leaning forward requires further diagnostic investigation, especially given the patient's history of syncope.
➡️ Crucial preparatory steps before taking BP readings include ensuring the patient has not consumed stimulants (coffee/tea), smoked, or engaged in physical activity within the preceding hours.
➡️ Proper disposal of medical waste (e.g., alcohol wipe in Class A, used stethoscope diaphragm/bell/wipes in Class B/P) is essential for infection control and safety protocols.

📸 Video summarized with SummaryTube.com on Oct 09, 2025, 03:43 UTC