Diffuse esophageal spasm physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
*Physical examination of patients with DES is usually remarkable for presence of features related to secondary diseases. | *Physical examination of patients with DES is usually remarkable for presence of features related to secondary [[diseases]]. | ||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
| Line 15: | Line 15: | ||
===Vital Signs=== | ===Vital Signs=== | ||
*High-grade / low-grade fever in infectious cause of DES | *High-grade / low-grade fever in [[infectious]] cause of DES | ||
*[[Hypothermia]] / hyperthermia may be present | *[[Hypothermia]] / [[hyperthermia]] may be present | ||
*[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse | *[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse | ||
*[[Bradycardia]] with regular pulse or (ir)regularly irregular pulse | *[[Bradycardia]] with regular pulse or (ir)regularly irregular pulse | ||
*Tachypnea / bradypnea | *[[Tachypnea]] / [[bradypnea]] | ||
* | *[[Kussmaul respirations]] | ||
*Weak/bounding pulse | *Weak / bounding pulse | ||
*High/low blood pressure with normal pulse pressure | *[[High blood pressure|High]] / [[low blood pressure]] with normal [[pulse pressure]] | ||
===Skin=== | ===Skin=== | ||
*Tight, hardened skin in limited scleroderma | *Tight, hardened skin in limited [[scleroderma]] | ||
*Red spots or lines in skin of face and hand due to | *Red spots or lines in skin of face and hand due to [[telangiectasia]] in [[scleroderma]] | ||
*Bumps under the skin due to deposition of calcium in scleroderma. | *Bumps under the skin due to deposition of [[calcium]] in [[scleroderma]]. | ||
*Ulcers of finger and toes may be present in scleroderma | *[[Ulcers]] of [[finger]] and [[toes]] may be present in [[scleroderma]] | ||
* Insect bite wound may be seen in Chaga's disease with excoriation at the bite site. | * Insect bite wound may be seen in [[Chagas disease|Chaga's disease]] with excoriation at the bite site. | ||
===HEENT=== | ===HEENT=== | ||
* Romana's sign is seen in Chaga's disease (swelling of eyelid at the site of parasite entry) | * [[Romana's sign]] is seen in [[Chagas disease|Chaga's disease]] (swelling of eyelid at the site of parasite entry) | ||
*Ophthalmoscopic exam may be abnormal with findings of diabetic retinopathy in diabetics as well as cataract changes. | *[[Ophthalmoscopy|Ophthalmoscopic]] exam may be abnormal with findings of [[diabetic retinopathy]] in [[diabetics]] as well as [[cataract]] changes. | ||
* Lower extremities edema in Chaga's disease. | * Lower extremities [[edema]] in [[Chagas disease|Chaga's disease]]. | ||
* Dry mouth and dry eye in scleroderma. | * Dry mouth and dry eye in [[scleroderma]]. | ||
===Neck=== | ===Neck=== | ||
*[[Lymphadenopathy]] (Chaga's disease) | *[[Lymphadenopathy]] (Chaga's disease) | ||
*[[Thyromegaly]] / thyroid nodules | *[[Thyromegaly]] / [[Thyroid nodule|thyroid nodules]] | ||
===Lungs=== | ===Lungs=== | ||
* Asymmetric chest expansion / Decreased chest expansion | * Asymmetric chest expansion / Decreased chest expansion | ||
*Lungs are hyperresonant in scleroderma. | *Lungs are hyperresonant in [[scleroderma]]. | ||
*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices bilaterally seen in scleroderma. | *Fine/coarse [[crackles]] upon auscultation of the lung bases/apices bilaterally seen in [[scleroderma]]. | ||
===Heart=== | ===Heart=== | ||
Heart involvement in Chagas's cardiomyopathy are: | Heart involvement in [[Chagas disease|Chagas's cardiomyopathy]] are: | ||
Displaced point of maximal impulse (PMI) | *Displaced [[point of maximal impulse]] (PMI). | ||
*[[Heart sounds#Third heart sound S3|S3]], [[S4]] | *[[Heart sounds#Third heart sound S3|S3]], [[S4]] | ||
*Disturbances of rhythm (arrhythmias) may be noted in scleroderma. | *Disturbances of rhythm ([[arrhythmias]]) may be noted in [[scleroderma]]. | ||
===Abdomen=== | ===Abdomen=== | ||
*[[Abdominal distention]] | *[[Abdominal distention]] or bloating is noted in [[Scleroderma]], [[Diabetes]]. | ||
*[[Hepatosplenomegaly]] is feature of [[Chagas disease|Chaga's disease]]. | |||
*[[ | |||
===Extremities=== | ===Extremities=== | ||
*[[Clubbing]] | *[[Clubbing]] , [[Cyanosis]] are features of chronic involvement and fibrosis of lungs in [[Scleroderma]]. | ||
*Pitting [[edema]] of the lower extremities may be noted in [[Chagas disease|Chaga's cardiomyopathy]]. | |||
*Pitting | |||
==References== | ==References== | ||
[[Category: (name of the system)]] | [[Category: (name of the system)]] | ||
Latest revision as of 14:30, 4 December 2017
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Diffuse esophageal spasm Microchapters |
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Differentiating Diffuse esophageal spasm from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Diffuse esophageal spasm physical examination On the Web |
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American Roentgen Ray Society Images of Diffuse esophageal spasm physical examination |
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Risk calculators and risk factors for Diffuse esophageal spasm physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Madhu Sigdel M.B.B.S.[2]
Overview
Patients with primary diffuse esophageal spasm usually appear normal. Physical examination of patients with DES is usually remarkable for findings related to secondary diseases.
Physical Examination
- Physical examination of patients with DES is usually remarkable for presence of features related to secondary diseases.
Appearance of the Patient
- Patients with primary DES usually appear normal.
Vital Signs
- High-grade / low-grade fever in infectious cause of DES
- Hypothermia / hyperthermia may be present
- Tachycardia with regular pulse or (ir)regularly irregular pulse
- Bradycardia with regular pulse or (ir)regularly irregular pulse
- Tachypnea / bradypnea
- Kussmaul respirations
- Weak / bounding pulse
- High / low blood pressure with normal pulse pressure
Skin
- Tight, hardened skin in limited scleroderma
- Red spots or lines in skin of face and hand due to telangiectasia in scleroderma
- Bumps under the skin due to deposition of calcium in scleroderma.
- Ulcers of finger and toes may be present in scleroderma
- Insect bite wound may be seen in Chaga's disease with excoriation at the bite site.
HEENT
- Romana's sign is seen in Chaga's disease (swelling of eyelid at the site of parasite entry)
- Ophthalmoscopic exam may be abnormal with findings of diabetic retinopathy in diabetics as well as cataract changes.
- Lower extremities edema in Chaga's disease.
- Dry mouth and dry eye in scleroderma.
Neck
- Lymphadenopathy (Chaga's disease)
- Thyromegaly / thyroid nodules
Lungs
- Asymmetric chest expansion / Decreased chest expansion
- Lungs are hyperresonant in scleroderma.
- Fine/coarse crackles upon auscultation of the lung bases/apices bilaterally seen in scleroderma.
Heart
Heart involvement in Chagas's cardiomyopathy are:
- Displaced point of maximal impulse (PMI).
- S3, S4
- Disturbances of rhythm (arrhythmias) may be noted in scleroderma.
Abdomen
- Abdominal distention or bloating is noted in Scleroderma, Diabetes.
- Hepatosplenomegaly is feature of Chaga's disease.
Extremities
- Clubbing , Cyanosis are features of chronic involvement and fibrosis of lungs in Scleroderma.
- Pitting edema of the lower extremities may be noted in Chaga's cardiomyopathy.