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Reviewed by the Faculty of Harvard Medical School

The General Examination

Even if you do everything right, your cardiovascular system (your heart and blood vessels) can still go wrong. That's why it's especially important to have your heart health evaluated by a doctor. There's no right answer about how often to see your doctor for regular check-ups, but many health professionals recommend a schedule like this:

  • Every five years for healthy adults under age 40
  • Every two to three years for healthy adults between ages 40 and 50
  • Every one to two years for healthy adults over age 50
The Physical Examination

During an exam, your doctor will want to know if you have any specific concerns or problems, such as chest pain or shortness of breath. He or she will review your medical history, including information about all past illnesses, hospitalizations, accidents, operations and allergies. Your doctor will ask about any medications you are taking. It's important to mention any over-the-counter drugs and dietary supplements (such as vitamins) that you take. Your doctor will want information about your lifestyle that may have an impact on heart disease, such as smoking, alcohol use, illegal drug use and any stress you experience.

During your cardiovascular physical examination, you doctor will look at some or all of the following:

  • Blood pressure. A doctor or nurse places a cuff over your upper arm and pumps it up with air. The nurse or doctor places a stethoscope in the crease of your elbow to listen to the blood flow in an artery. Blood pressure is measured as one number over another. The first number, called systolic pressure, measures the pressure in your artery when blood is being pumped through. The second number, called diastolic pressure, measures the pressure in the artery between heartbeats. A reading of 120/80 or lower is normal. A reading above 140/90 is considered high (Readings between 120 and 140 and 80 and 90 are in a range called "prehypertension.")
  • Heart rate and rhythm. Your doctor or a nurse feels the pulse at your wrist to determine your heart rate and rhythm. (This information cane also be collected while listening to your heart.)
  • Pulses. Your doctor will feel pulse points in your neck, groin and feet, and will use a stethoscope to listen to the arteries in your neck. Weak or missing pulses, or abnormal sounds in the neck, suggest narrowed blood vessels.
  • Swelling. Your doctor will routinely examine your legs and ankles for swelling, also called edema. Edema may develop with heart disease, kidney disease and liver disease or with a blockage in a vein carrying blood back to the heart. Your doctor will press on the skin and watch how far it can be indented. Edema is present if your skin does not spring back promptly. In other words, the indentation remains longer than it should.
  • Breath sounds. Using a stethoscope, your doctor will try to determine whether fluid has leaked into the lungs' air sacs. The presence of fluid, which makes a crackling or wet sound, may be a sign of heart disease.
  • Heart sounds. Your doctor will check for a regular heartbeat and listen for unusual sounds (murmurs), which would indicate a narrowed or leaky heart valve.
  • Color. Bluish lips and fingertips may indicate that your heart is not providing your body with enough oxygen. Pale skin under the fingernails can be a sign of anemia or poor blood flow.
  • Eyes. Using a special viewing device, your doctor will check the vessels in the back of your eyes to see if they are abnormal or diseased, which may be an indication of how other vessels in your body look.

Last updated June 20, 2008




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