Primary hyperaldosteronism physical examination: Difference between revisions
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{{ | {{Primary hyperaldosteronism}} | ||
{{CMG}}; {{AE}} {{HK}} | |||
== Overview == | |||
Patients with primary hyperaldosteronism usually appear well. Physical examination of patients with primary hyperaldosteronism is usually remarkable for high [[blood pressure]], [[tachycardia]], and an [[S4]] maybe heard on auscultation of the [[precordium]] suggesting [[left ventricular hypertrophy]] secondary to increased [[afterload]] due to [[hypertension]]. | |||
== Physical Examination == | == Physical Examination == | ||
=== Appearance of the patient === | === Appearance of the patient === | ||
* Patient is usually well-appearing. | |||
=== Vital signs === | === Vital signs === | ||
* Normal [[body temperature]] | |||
* [[Tachycardia]] with [[irregular pulse]]<ref name="pmid19946238">{{cite journal |vauthors=Zelinka T, Holaj R, Petrák O, Strauch B, Kasalický M, Hanus T, Melenovský V, Vancura V, Bürgelová M, Widimský J |title=Life-threatening arrhythmia caused by primary aldosteronism |journal=Med. Sci. Monit. |volume=15 |issue=12 |pages=CS174–7 |year=2009 |pmid=19946238 |doi= |url=}}</ref><ref name="pmid11045185">{{cite journal |vauthors=Pella J, Lazúrová I, Javorská B, Trejbal D |title=[Conn's syndrome and severe arrhythmias] |language=Slovak |journal=Vnitr Lek |volume=45 |issue=4 |pages=228–31 |year=1999 |pmid=11045185 |doi= |url=}}</ref> | |||
* Normal [[respiratory rate]] | |||
* High [[blood pressure]] may be the only presenting sign | |||
=== | === Neck === | ||
* No [[lymphadenopathy]] | |||
* No [[thyromegaly]] | |||
* Elevated [[Jugular venous pressure|JVP]] | |||
=== Lungs === | === Lungs === | ||
* Symmetric chest expansion | |||
* Normal breath sounds | |||
* No [[rales]], rhonchi and [[wheeze]] | |||
=== Heart === | === Heart === | ||
* [[Point of maximal impulse|Point of maximal impulse (PMI)]] within 2 cm of the [[sternum]] | |||
=== | * Normal [[Heart sounds#First heart tone S1.2C the .22lub.22.28components M1 and T1.29|S1]] and [[Heart sounds#Second heart tone S2 the .22dub.22.28components A2 and P2.29|S2]] | ||
* [[Heart sounds#Fourth heart sound S4|S4]] may be heard due to [[left ventricular hypertrophy]]<ref name="pmid15291171">{{cite journal |vauthors=du Cailar G |title=[Cardiac consequences of primary hyperaldosteronism] |language=French |journal=Ann Cardiol Angeiol (Paris) |volume=53 |issue=3 |pages=147–9 |year=2004 |pmid=15291171 |doi= |url= |issn=}}</ref> | |||
=== | * No [[gallop rhythm]] | ||
= | |||
=== Neurologic === | === Neurologic === | ||
* Hyperaldosteronism induced [[hypertension]] may lead to [[stroke]] and [[paralysis]]<ref name="pmid10023636">{{cite journal |vauthors=Nishimura M, Uzu T, Fujii T, Kuroda S, Nakamura S, Inenaga T, Kimura G |title=Cardiovascular complications in patients with primary aldosteronism |journal=Am. J. Kidney Dis. |volume=33 |issue=2 |pages=261–6 |year=1999 |pmid=10023636 |doi= |url= |issn=}}</ref> | |||
==References== | ==References== | ||
Latest revision as of 17:15, 3 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]
Overview
Patients with primary hyperaldosteronism usually appear well. Physical examination of patients with primary hyperaldosteronism is usually remarkable for high blood pressure, tachycardia, and an S4 maybe heard on auscultation of the precordium suggesting left ventricular hypertrophy secondary to increased afterload due to hypertension.
Physical Examination
Appearance of the patient
- Patient is usually well-appearing.
Vital signs
- Normal body temperature
- Tachycardia with irregular pulse[1][2]
- Normal respiratory rate
- High blood pressure may be the only presenting sign
Neck
- No lymphadenopathy
- No thyromegaly
- Elevated JVP
Lungs
Heart
- Point of maximal impulse (PMI) within 2 cm of the sternum
- Normal S1 and S2
- S4 may be heard due to left ventricular hypertrophy[3]
- No gallop rhythm
Neurologic
- Hyperaldosteronism induced hypertension may lead to stroke and paralysis[4]
References
- ↑ Zelinka T, Holaj R, Petrák O, Strauch B, Kasalický M, Hanus T, Melenovský V, Vancura V, Bürgelová M, Widimský J (2009). "Life-threatening arrhythmia caused by primary aldosteronism". Med. Sci. Monit. 15 (12): CS174–7. PMID 19946238.
- ↑ Pella J, Lazúrová I, Javorská B, Trejbal D (1999). "[Conn's syndrome and severe arrhythmias]". Vnitr Lek (in Slovak). 45 (4): 228–31. PMID 11045185.
- ↑ du Cailar G (2004). "[Cardiac consequences of primary hyperaldosteronism]". Ann Cardiol Angeiol (Paris) (in French). 53 (3): 147–9. PMID 15291171.
- ↑ Nishimura M, Uzu T, Fujii T, Kuroda S, Nakamura S, Inenaga T, Kimura G (1999). "Cardiovascular complications in patients with primary aldosteronism". Am. J. Kidney Dis. 33 (2): 261–6. PMID 10023636.