Eisenmenger’s syndrome physical examination: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
 
(5 intermediate revisions by the same user not shown)
Line 3: Line 3:
{{CMG}}; {{AE}}{{AIA}}
{{CMG}}; {{AE}}{{AIA}}
==Overview==
==Overview==
The general examination of patients with Eisenmenger's syndrome may show [[cyanosis]], dermal changes, [[clubbing]], [[peripheral edema]], and abdominal swelling. Cardiac examination may show [[A wave]] dominant [[Jugular venous pressure|jugular venous pulse]], right ventricular [[heave]], high-pitched early diastolic [[Heart murmur|murmur]] of [[pulmonary insufficiency]], right-sided [[S4]], pulmonary ejection click, single palpable [[S2|S<sub>2</sub>]], and loud [[P2|P<sub>2</sub>]].


==Physical Examination==
==Physical Examination==
The physical examination of patients with [[Eisenmenger's syndrome]] may show the following<ref name="pmid22043211">{{cite journal| author=Kaemmerer H, Mebus S, Schulze-Neick I, Eicken A, Trindade PT, Hager A et al.| title=The adult patient with eisenmenger syndrome: a medical update after dana point part I: epidemiology, clinical aspects and diagnostic options. | journal=Curr Cardiol Rev | year= 2010 | volume= 6 | issue= 4 | pages= 343-55 | pmid=22043211 | doi=10.2174/157340310793566154 | pmc=3083816 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22043211  }}</ref><ref name="pmid201964692">{{cite journal| author=Iveta S| title=Eisenmenger syndrome--a unique form of pulmonary arterial hypertension. | journal=Bratisl Lek Listy | year= 2009 | volume= 110 | issue= 12 | pages= 757-64 | pmid=20196469 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20196469  }}</ref><ref name="pmid9556469">{{cite journal| author=Vongpatanasin W, Brickner ME, Hillis LD, Lange RA| title=The Eisenmenger syndrome in adults. | journal=Ann Intern Med | year= 1998 | volume= 128 | issue= 9 | pages= 745-55 | pmid=9556469 | doi=10.7326/0003-4819-128-9-199805010-00008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9556469  }}</ref>:


=== Appearance of the Patient ===
=== Appearance of the Patient ===


* Patients with [disease name] usually appear [general appearance].
* Patients with [[Eisenmenger's syndrome]] usually appear lethargic and cyanotic.


=== Vital Signs ===
=== Vital Signs ===


* [[Hypothermia]] / hyperthermia may be present
* [[Tachycardia]]  
* [[Tachycardia]] with regular pulse or (ir)regularly irregular pulse
*[[Tachypnea]]
* [[Bradycardia]] with regular pulse or (ir)regularly irregular pulse
*[[Postural hypotension]]
* Tachypnea / bradypnea
* Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
* High/low blood pressure with normal pulse pressure / [[wide pulse pressure]] / [[narrow pulse pressure]]


=== Skin ===
=== Skin ===
Skin examination of patients with Eisenmenger's syndrome usually shows:


* Skin examination of patients with [disease name] is usually normal.
*[[Plethora]]
*[[Livedo reticularis]]
*Profound [[acrocyanosis]]
*[[Urate]] depositions
*[[Ecchymosis]]
*Ischemic skin [[ulcerations]]


=== HEENT ===
=== HEENT ===


* HEENT examination of patients with [disease name] is usually normal.
* HEENT examination of patients with [[Eisenmenger's syndrome]] is usually normal.


=== Neck ===
=== Neck ===


* [[Jugular venous distension]]
* [[Jugular venous distension]]
* [[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
* [[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
* [[Thyromegaly]] / thyroid nodules
* [[Hepatojugular reflux]]
* [[Hepatojugular reflux]]


=== Lungs ===
=== Lungs ===


* Pulmonary examination of patients with [disease name] is usually normal.
* Pulmonary examination of patients with [[Eisenmenger's syndrome]] is usually normal.


===Heart===
===Heart===
* Jugular venous pressure may be raised with 'a' wave indicating increased right atrial pressure. A 'v' wave indicating development of tricuspid regurgitation may also be seen
 
* Right ventricular heave and thrill
* [[Jugular venous pressure|Jugular venous pulse]] wave may be [[A wave]] dominant
* Murmurs of tricuspid and pulmonic regurgitation maybe audible.
* Precordial palpation reveals a right ventricular [[heave]]
* Loud P2
* High-pitched early diastolic [[Heart murmur|murmur]] of [[pulmonary insufficiency]]
* Ejection click
* Right-sided [[S4]]
* Pulmonary ejection click
* Single palpable [[S2|S<sub>2</sub>]]
* Loud [[P2|P<sub>2</sub>]]


===Abdomen===
===Abdomen===
* [[Hepatomegaly]]
* [[Hepatomegaly]]
* [[Ascites]]
*[[Jaundice]]
*Right upper abdominal quadrant [[tenderness]]


=== Back ===
=== Back ===


* Back examination of patients with [disease name] is usually normal.
* Back examination of patients with [[Eisenmenger's syndrome]] is usually normal.


=== Genitourinary ===
=== Genitourinary ===


* Genitourinary examination of patients with [disease name] is usually normal.
* Genitourinary examination of patients with [[Eisenmenger's syndrome]] is usually normal.


=== Neuromuscular ===
=== Neuromuscular ===


* Neuromuscular examination of patients with [disease name] is usually normal.
* Neuromuscular examination of patients with [[Eisenmenger's syndrome]] is usually normal.


===Extremities===
===Extremities===
* Central [[cyanosis]]
* C[[cyanosis|yanosis]]
* [[Clubbing]]  
* [[Clubbing]]  
* Peripheral [[edema]]
* Peripheral [[edema]]


[[File:ClubbingFingers1.jpg|center|thumb|Nail clubbing of fingers in a patient with Eisenmenger's syndrome. Case courtsey of Ann McGrath [Public domain].<ref>https://en.wikipedia.org/wiki/Eisenmenger%27s_syndrome#/media/File:ClubbingFingers1.jpg/</ref>]]
<br />
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Latest revision as of 15:01, 20 January 2020

Eisenmenger’s syndrome Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Eisenmenger’s syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Eisenmenger’s syndrome ACC/AHA Guidelines for Evaluation of Patients

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

ACC/AHA Guidelines for Reproduction

Eisenmenger’s syndrome physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Eisenmenger’s syndrome physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Eisenmenger’s syndrome physical examination

CDC on Eisenmenger’s syndrome physical examination

Eisenmenger’s syndrome physical examination in the news

Blogs on Eisenmenger’s syndrome physical examination

Directions to Hospitals Treating Type page name here

Risk calculators and risk factors for Eisenmenger’s syndrome physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdelrahman Ibrahim Abushouk, MD[2]

Overview

The general examination of patients with Eisenmenger's syndrome may show cyanosis, dermal changes, clubbing, peripheral edema, and abdominal swelling. Cardiac examination may show A wave dominant jugular venous pulse, right ventricular heave, high-pitched early diastolic murmur of pulmonary insufficiency, right-sided S4, pulmonary ejection click, single palpable S2, and loud P2.

Physical Examination

The physical examination of patients with Eisenmenger's syndrome may show the following[1][2][3]:

Appearance of the Patient

Vital Signs

Skin

Skin examination of patients with Eisenmenger's syndrome usually shows:

HEENT

Neck

Lungs

Heart

Abdomen

Back

Genitourinary

Neuromuscular

Extremities

Nail clubbing of fingers in a patient with Eisenmenger's syndrome. Case courtsey of Ann McGrath [Public domain].[4]


References

  1. ↑ Kaemmerer H, Mebus S, Schulze-Neick I, Eicken A, Trindade PT, Hager A; et al. (2010). "The adult patient with eisenmenger syndrome: a medical update after dana point part I: epidemiology, clinical aspects and diagnostic options". Curr Cardiol Rev. 6 (4): 343–55. doi:10.2174/157340310793566154. PMC 3083816. PMID 22043211.
  2. ↑ Iveta S (2009). "Eisenmenger syndrome--a unique form of pulmonary arterial hypertension". Bratisl Lek Listy. 110 (12): 757–64. PMID 20196469.
  3. ↑ Vongpatanasin W, Brickner ME, Hillis LD, Lange RA (1998). "The Eisenmenger syndrome in adults". Ann Intern Med. 128 (9): 745–55. doi:10.7326/0003-4819-128-9-199805010-00008. PMID 9556469.
  4. ↑ https://en.wikipedia.org/wiki/Eisenmenger%27s_syndrome#/media/File:ClubbingFingers1.jpg/

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Eisenmenger’s_syndrome_physical_examination&oldid=1595834"