Marfan's syndrome physical examination: Difference between revisions
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=== Eyes === | === Eyes === | ||
[[Image:Lens marfan.gif|thumb|left|160px|Lens dislocation in Marfan's syndrome, the lens was kidney-shaped and was resting against the [[ciliary body]].]] | [[Image:Lens marfan.gif|thumb|left|160px|Lens dislocation in Marfan's syndrome, the lens was kidney-shaped and was resting against the [[ciliary body]].]] | ||
* | * [[myopia|Nearsightedness]] and [[astigmatism (eye)|astigmatism]] are common, but farsightedness can also result. | ||
* [[Subluxation]] (dislocation) of the crystalline [[lens (anatomy)|lens]] in one or both eyes (''[[ectopia lentis]]'') (in 80% of patients) also occurs and may be detected by an [[ophthalmologist]] or [[optometrist]] using a [[Slit lamp|slit-lamp]] biomicroscope. | |||
* In Marfan's the dislocation is typically superotemporal whereas in the similar condition [[homocystinuria]], the dislocation is inferonasal. | |||
* Sometimes eye problems appear only after the weakening of connective tissue has caused [[retinal detachment|detachment of the retina]]. | |||
* Sometimes eye problems appear only after the weakening of connective tissue has caused [[retinal detachment|detachment of the retina]]. | |||
* Early onset [[glaucoma]] can be another related problem. | * Early onset [[glaucoma]] can be another related problem. | ||
<br clear="left"/> | <br clear="left"/> | ||
=== Heart === | === Heart === | ||
* [[Heart palpitations]] | * [[Heart palpitations]] | ||
* [[tachycardia|Racing heartbeats]] | * [[tachycardia|Racing heartbeats]] | ||
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*[[Cyanosis]] | *[[Cyanosis]] | ||
* Marfan syndrome has also been associated with [[sleep apnea]] and [[idiopathic]] obstructive lung disease. | * Marfan syndrome has also been associated with [[sleep apnea]] and [[idiopathic]] obstructive lung disease. | ||
=== Extremities === | === Extremities === | ||
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* [[Dural ectasia]], the weakening of the connective tissue of the dural sac, the membrane that encases the [[spinal cord]]. | * [[Dural ectasia]], the weakening of the connective tissue of the dural sac, the membrane that encases the [[spinal cord]]. | ||
** Dural ectasia can be present for a long time without producing any noticeable symptoms. Symptoms that can occur are lower [[back pain]], leg pain, [[abdominal pain]], other neurological symptoms in the lower extremities, or [[headaches]]. Such symptoms usually diminish when the individual lies flat on his or her back. | ** Dural ectasia can be present for a long time without producing any noticeable symptoms. Symptoms that can occur are lower [[back pain]], leg pain, [[abdominal pain]], other neurological symptoms in the lower extremities, or [[headaches]]. Such symptoms usually diminish when the individual lies flat on his or her back. | ||
=== Other === | === Other === | ||
Latest revision as of 15:20, 22 August 2012
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Marfan's syndrome Microchapters | |
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Diagnosis | |
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Treatment | |
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Marfan's syndrome physical examination On the Web | |
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American Roentgen Ray Society Images of Marfan's syndrome physical examination | |
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Risk calculators and risk factors for Marfan's syndrome physical examination | |
Editors-In-Chief: William James Gibson, C. Michael Gibson, M.S., M.D.
Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [1] ; Assistant Editor-In-Chief: Cassandra Abueg, M.P.H. [2]
Overview
Physical Examination
Appearance of the Patient
- Many individuals with Marfan Syndrome grow to above average height.
- Undue fatigue
Vital Signs
Within normal limits.
Skin
- Unexplained stretch marks on the skin
Head
- Symptomatic high palates and small jaws.
Eyes
- Nearsightedness and astigmatism are common, but farsightedness can also result.
- Subluxation (dislocation) of the crystalline lens in one or both eyes (ectopia lentis) (in 80% of patients) also occurs and may be detected by an ophthalmologist or optometrist using a slit-lamp biomicroscope.
- In Marfan's the dislocation is typically superotemporal whereas in the similar condition homocystinuria, the dislocation is inferonasal.
- Sometimes eye problems appear only after the weakening of connective tissue has caused detachment of the retina.
- Early onset glaucoma can be another related problem.
Heart
- Heart palpitations
- Racing heartbeats
- Pain in the left chest, back, shoulder, or arm
- Heart murmur heard on a stethoscope
- An abnormal reading on an electrocardiogram
- Leakage or prolapse of the mitral or aortic valves that control the flow of blood through the heart. (See mitral valve prolapse.)
- Dilated aorta or an aortic aneurysm or even aortic dissection
- There is an increased incidence of dehiscence of prosthetic mitral valve.[1] Care should be taken to attempt repair of damaged heart valves rather than replacement.
Lungs
- Spontaneous pneumothorax
- Shortness of breath
- Cyanosis
- Marfan syndrome has also been associated with sleep apnea and idiopathic obstructive lung disease.
Extremities
- Some have long slender limbs with fingers and toes that are also abnormally long and slender (arachnodactyly).
- An individual's arms may be disproportionately long.
- Abnormal joint flexibility
- Flat feet, stooped shoulders
Neurologic
- Some people with Marfans have speech disorders.
- Dural ectasia, the weakening of the connective tissue of the dural sac, the membrane that encases the spinal cord.
- Dural ectasia can be present for a long time without producing any noticeable symptoms. Symptoms that can occur are lower back pain, leg pain, abdominal pain, other neurological symptoms in the lower extremities, or headaches. Such symptoms usually diminish when the individual lies flat on his or her back.
Other
- Abnormal curvature of the spine (scoliosis) is common, as is abnormal indentation (pectus excavatum) or protrusion (pectus carinatum) of the sternum.
- Degenerative disk disease and spinal cysts