Cardiac amyloidosis physical examination: Difference between revisions
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{{Cardiac amyloidosis}} | {{Cardiac amyloidosis}} | ||
{{CMG}}; | {{CMG}}; {{AE}} {{RT}}; {{AN}}; {{CZ}}; {{LG}} | ||
== | ==Overview== | ||
Cardiac amyloidosis is difficult to diagnose. | Cardiac amyloidosis is difficult to [[Diagnosis|diagnose]]. More than 50% of the [[Patient|patients]] with cardiac amyloidosis present with [[Medical sign|signs]] and [[Symptom|symptoms]] suggestive of [[right heart failure]]. Common [[physical exam]] findings include elevated [[jugular venous pressure]], [[third heart sound]] and [[pedal edema]]. | ||
The | ==Physical Examination== | ||
===Vitals=== | |||
====Blood Pressure==== | |||
The blood pressure may be low or may drop when rising to a standing position ([[orthostatic hypotension]]). Orthostatic hypotension is typically observed among patients with kidney involvement. [[Low cardiac output]] and/or inappropriate peripheral [[vasodilation]] can also contribute to [[hypotension]]. | |||
===Head and Neck=== | |||
*[[Jugular venous pressure|Elevated jugular pressure]] | |||
* Periorbital [[purpura]]: Often occurs with sneezing, coughing or with minor trauma. Indicates capillary involvement of [[AL type amyloidosis]]. | |||
* [[Macroglossia]] | |||
* Abnormal phonation | |||
===Extremities=== | |||
*[[Pedal edema]] | |||
===Abdomen=== | |||
*[[Hepatomegaly]] may be present in the setting of [[right heart failure]] | |||
*[[Ascites]] may be present in the setting of [[right heart failure]] | |||
*[[Splenomegaly]] is rare | |||
===Heart=== | |||
====Auscultation==== | |||
* [[Third heart sound]] | |||
* [[Fourth heart sound]] | |||
*[[Arrhythmias]] <ref name="pmid17062380">{{cite journal |author=Rapezzi C, Perugini E, Salvi F, Grigioni F, Riva L, Cooke RM, Ferlini A, Rimessi P, Bacchi-Reggiani L, Ciliberti P, Pastorelli F, Leone O, Bartolomei I, Pinna AD, Arpesella G, Branzi A |title=Phenotypic and genotypic heterogeneity in transthyretin-related cardiac amyloidosis: towards tailoring of therapeutic strategies? |journal=[[Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis]] |volume=13 |issue=3 |pages=143–53 |year=2006 |month=September |pmid=17062380 |doi=10.1080/13506120600877136 |url=http://informahealthcare.com/doi/abs/10.1080/13506120600877136 |accessdate=2012-02-13}}</ref> | |||
*Auscultation may also reveal [[rales]], [[heart murmur]]s, and/or other pathologic heart sounds. | |||
* In patients with [[valvular heart disease]] involvement, murmurs of [[mitral regurgitation|mitral]] and [[tricuspid regurgitation]] may be heard. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WikiDoc Help Menu}} | |||
{{WikiDoc Sources}} | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Rheumatology]] | [[Category:Rheumatology]] | ||
Latest revision as of 21:04, 17 December 2019
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Cardiac amyloidosis physical examination On the Web |
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American Roentgen Ray Society Images of Cardiac amyloidosis physical examination |
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Risk calculators and risk factors for Cardiac amyloidosis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]; Aarti Narayan, M.B.B.S [3]; Cafer Zorkun, M.D., Ph.D. [4]; Lakshmi Gopalakrishnan, M.B.B.S. [5]
Overview
Cardiac amyloidosis is difficult to diagnose. More than 50% of the patients with cardiac amyloidosis present with signs and symptoms suggestive of right heart failure. Common physical exam findings include elevated jugular venous pressure, third heart sound and pedal edema.
Physical Examination
Vitals
Blood Pressure
The blood pressure may be low or may drop when rising to a standing position (orthostatic hypotension). Orthostatic hypotension is typically observed among patients with kidney involvement. Low cardiac output and/or inappropriate peripheral vasodilation can also contribute to hypotension.
Head and Neck
- Elevated jugular pressure
- Periorbital purpura: Often occurs with sneezing, coughing or with minor trauma. Indicates capillary involvement of AL type amyloidosis.
- Macroglossia
- Abnormal phonation
Extremities
Abdomen
- Hepatomegaly may be present in the setting of right heart failure
- Ascites may be present in the setting of right heart failure
- Splenomegaly is rare
Heart
Auscultation
- Third heart sound
- Fourth heart sound
- Arrhythmias [1]
- Auscultation may also reveal rales, heart murmurs, and/or other pathologic heart sounds.
- In patients with valvular heart disease involvement, murmurs of mitral and tricuspid regurgitation may be heard.
References
- ↑ Rapezzi C, Perugini E, Salvi F, Grigioni F, Riva L, Cooke RM, Ferlini A, Rimessi P, Bacchi-Reggiani L, Ciliberti P, Pastorelli F, Leone O, Bartolomei I, Pinna AD, Arpesella G, Branzi A (2006). "Phenotypic and genotypic heterogeneity in transthyretin-related cardiac amyloidosis: towards tailoring of therapeutic strategies?". Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis. 13 (3): 143–53. doi:10.1080/13506120600877136. PMID 17062380. Retrieved 2012-02-13. Unknown parameter
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