General inspection

During this the following are assessed:

• Respiration
  • Respiratory rate.
    A faster respiratory rate (>20/min) is termed tachypnoea.
  • Shortness of breath (dyspnoea)
    In the case of dyspnoea a distinction is made between exertional dyspnoea (on exertion), dyspnoea at rest and dyspnoea while lying down (orthopnoea)
• The presence of oedema (fluid accumulation)
• The presence of a bluish discolouration of the lips, tongue, face, fingers/toes (cyanosis)
• The presence of perspiration.

Dyspnoea, orthopnoea, tachypnoea and oedema can be indicative of congestive heart failure. Blue discolouration of the toes and fingers is termed peripheral cyanosis.
This is usually indicative of circulatory disorders. A blue discolouration of the lips and tongue is termed central cyanosis.
This is indicative of reduced oxygenation (oxygen tension) in the blood. Instead of blue, the face may be pale, for example in the event of anaemia or cardiogenic shock (low blood pressure due to failure of the heart to pump effectively).
In the case of mitral stenosis (restriction of the mitral valve) the cheeks are often very red (blushing).