Tuberculous pericarditis physical examination: Difference between revisions
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{{Tuberculous pericarditis}} | {{Tuberculous pericarditis}} | ||
{{CMG}}; '''Associate Editor-In-Chief:''' [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S. | {{CMG}}; '''Associate Editor-In-Chief:''' {{Fs}} [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S. | ||
==Overview== | |||
Patients with tuberculous pericarditis usually appear [[Cachexia|Cachectic]]. They may have [[fever]], [[tachycardia]], [[pulsus paradoxus]], [[hypotension]], [[tachypnea]], [[JVP]] distension, [[kussmaul's sign]], [[lymphadenopathy]], [[ankle edama]], [[pleura]] dullness, decreased [[breath sounds]], [[pericardial]] knock, [[pericardial rub]], fine/coarse [[crackles]] upon auscultation of the lung, [[hepatomegaly]], [[Ascites, pleural effusion, and benign ovarian tumor.|ascites]], distant [[heart sounds]], displaced point of maximal impulse (PMI) suggestive of [[cardiomegaly]], [[friction rub]], and [[Heart sounds#Fourth heart sound S4|S4]]. | |||
==Physical Examination== | ==Physical Examination== | ||
=== | ===Appearance of the Patient=== | ||
[[ | *Patients with tuberculous pericarditis usually appear Cachectic.<ref name="pmid4593515">{{cite journal |vauthors=Fowler NO, Manitsas GT |title=Infectious pericarditis |journal=Prog Cardiovasc Dis |volume=16 |issue=3 |pages=323–36 |date=1973 |pmid=4593515 |doi=10.1016/s0033-0620(73)80004-0 |url=}}</ref><ref name="MayosiWiysonge2006">{{cite journal|last1=Mayosi|first1=Bongani M|last2=Wiysonge|first2=Charles Shey|last3=Ntsekhe|first3=Mpiko|last4=Volmink|first4=Jimmy A|last5=Gumedze|first5=Freedom|last6=Maartens|first6=Gary|last7=Aje|first7=Akinyemi|last8=Thomas|first8=Baby M|last9=Thomas|first9=Kandathil M|last10=Awotedu|first10=Abolade A|last11=Thembela|first11=Bongani|last12=Mntla|first12=Phindile|last13=Maritz|first13=Frans|last14=Blackett|first14=Kathleen Ngu|last15=Nkouonlack|first15=Duquesne C|last16=Burch|first16=Vanessa C|last17=Rebe|first17=Kevin|last18=Parish|first18=Andy|last19=Sliwa|first19=Karen|last20=Vezi|first20=Brian Z|last21=Alam|first21=Nowshad|last22=Brown|first22=Basil G|last23=Gould|first23=Trevor|last24=Visser|first24=Tim|last25=Shey|first25=Muki S|last26=Magula|first26=Nombulelo P|last27=Commerford|first27=Patrick J|title=Clinical characteristics and initial management of patients with tuberculous pericarditis in the HIV era: the Investigation of the Management of Pericarditis in Africa (IMPI Africa) registry|journal=BMC Infectious Diseases|volume=6|issue=1|year=2006|issn=1471-2334|doi=10.1186/1471-2334-6-2}}</ref> | ||
===Vital Signs=== | |||
* [[Fever]] | |||
* [[Tachycardia]] | |||
* [[Pulsus paradoxus]] | |||
* Hypotension (in [[cardiac tamponade]]) | |||
*Tachypnea | |||
===Skin=== | |||
* Skin examination of patients with tuberculous pericarditis is usually normal. | |||
=== | ===HEENT=== | ||
* HEENT examination of patients with tuberculous pericarditis is usually normal. | |||
===Neck=== | ===Neck=== | ||
=== | *[[Jugular venous distension]] | ||
*[[Kussmaul's sign]] | |||
*[[Lymphadenopathy]] | |||
===Lungs=== | |||
* Pleura dullness | |||
* Decreased breath sounds | |||
* Pericardial knock | |||
* Pericardial rub | |||
*Fine/coarse [[crackles]] upon auscultation of the lung | |||
===Heart=== | |||
* Distant [[heart sounds]] | |||
*Displaced point of maximal impulse (PMI) suggestive of cardiomegaly | |||
*[[Friction rub]] | |||
* | |||
*[[Heart sounds#Fourth heart sound S4|S4]] | |||
*[[Heart sounds#Summation Gallop|Gallops]] | |||
*A high/low grade early/late [[systolic murmur]] / [[diastolic murmur]] best heard at the base/apex/(specific valve region) may be heard using the bell/diaphgram of the stethoscope | |||
===Abdomen=== | ===Abdomen=== | ||
[[Hepatomegaly]] | |||
*[[Hepatomegaly]] | |||
*Ascites | |||
===Back=== | |||
* Back examination of patients with tuberculous pericarditis is usually normal. | |||
===Genitourinary=== | |||
* Genitourinary examination of patients with tuberculous pericarditis is usually normal. | |||
===Neuromuscular=== | |||
* Neuromuscular examination of patients with tuberculous pericarditis is usually normal. | |||
===Extremities=== | ===Extremities=== | ||
[[ | |||
*Pitting [[edema]] of the lower extremities | |||
==References== | ==References== | ||
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[[Category:Inflammations]] | [[Category:Inflammations]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category: | |||
[[Category: | [[Category:Tuberculosis]] | ||
[[Category: | [[Category:Disease]] | ||
[[Category:Needs overview]] | |||
Latest revision as of 15:58, 19 December 2019
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Tuberculous pericarditis Microchapters |
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Differentiating Tuberculous pericarditis from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Tuberculous pericarditis physical examination On the Web |
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American Roentgen Ray Society Images of Tuberculous pericarditis physical examination |
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Risk calculators and risk factors for Tuberculous pericarditis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Fahimeh Shojaei, M.D. Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.
Overview
Patients with tuberculous pericarditis usually appear Cachectic. They may have fever, tachycardia, pulsus paradoxus, hypotension, tachypnea, JVP distension, kussmaul's sign, lymphadenopathy, ankle edama, pleura dullness, decreased breath sounds, pericardial knock, pericardial rub, fine/coarse crackles upon auscultation of the lung, hepatomegaly, ascites, distant heart sounds, displaced point of maximal impulse (PMI) suggestive of cardiomegaly, friction rub, and S4.
Physical Examination
Appearance of the Patient
Vital Signs
- Fever
- Tachycardia
- Pulsus paradoxus
- Hypotension (in cardiac tamponade)
- Tachypnea
Skin
- Skin examination of patients with tuberculous pericarditis is usually normal.
HEENT
- HEENT examination of patients with tuberculous pericarditis is usually normal.
Neck
Lungs
- Pleura dullness
- Decreased breath sounds
- Pericardial knock
- Pericardial rub
- Fine/coarse crackles upon auscultation of the lung
Heart
- Distant heart sounds
- Displaced point of maximal impulse (PMI) suggestive of cardiomegaly
- Friction rub
- S4
- Gallops
- A high/low grade early/late systolic murmur / diastolic murmur best heard at the base/apex/(specific valve region) may be heard using the bell/diaphgram of the stethoscope
Abdomen
- Hepatomegaly
- Ascites
Back
- Back examination of patients with tuberculous pericarditis is usually normal.
Genitourinary
- Genitourinary examination of patients with tuberculous pericarditis is usually normal.
Neuromuscular
- Neuromuscular examination of patients with tuberculous pericarditis is usually normal.
Extremities
- Pitting edema of the lower extremities
References
- ↑ Fowler NO, Manitsas GT (1973). "Infectious pericarditis". Prog Cardiovasc Dis. 16 (3): 323–36. doi:10.1016/s0033-0620(73)80004-0. PMID 4593515.
- ↑ Mayosi, Bongani M; Wiysonge, Charles Shey; Ntsekhe, Mpiko; Volmink, Jimmy A; Gumedze, Freedom; Maartens, Gary; Aje, Akinyemi; Thomas, Baby M; Thomas, Kandathil M; Awotedu, Abolade A; Thembela, Bongani; Mntla, Phindile; Maritz, Frans; Blackett, Kathleen Ngu; Nkouonlack, Duquesne C; Burch, Vanessa C; Rebe, Kevin; Parish, Andy; Sliwa, Karen; Vezi, Brian Z; Alam, Nowshad; Brown, Basil G; Gould, Trevor; Visser, Tim; Shey, Muki S; Magula, Nombulelo P; Commerford, Patrick J (2006). "Clinical characteristics and initial management of patients with tuberculous pericarditis in the HIV era: the Investigation of the Management of Pericarditis in Africa (IMPI Africa) registry". BMC Infectious Diseases. 6 (1). doi:10.1186/1471-2334-6-2. ISSN 1471-2334.