Thoracic aortic aneurysm physical examination: Difference between revisions
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{{Template:Thoracic aortic aneurysm}} | {{Template:Thoracic aortic aneurysm}} | ||
{{CMG}} {{AE}} [[User:Mohammad Salih|Mohammad Salih, MD.]] | |||
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==Overview== | ==Overview== | ||
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==Physical Examination== | ==Physical Examination== | ||
===General=== | ===General=== | ||
The patient may be hoarse in the presence of an arch aneurysm due to compression of the [[recurrent laryngeal nerve]]. | |||
===Vitals=== | ===Vitals=== | ||
A [[widened pulse pressure]] may be present due to [[aortic insufficiency]] in the presence of an ascending aortic aneurysm. | |||
===Neck=== | ===Neck=== | ||
Signs of [[superior vena cava obstruction]] such as a swollen face and neck may be present in the presence of an ascending aortic aneurysm. | |||
===Cardiac=== | ===Cardiac=== | ||
Signs of [[aortic insufficiency]] and [[left ventricular failure|left ventricular heart failure]] may be present in the presence of an ascending aortic aneurysm. | |||
===Pulmonary=== | ===Pulmonary=== | ||
[[Stridor]] and [[wheezing]] may be present in the presence of a descending aorta aneurysm. | |||
==2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease (DO NOT EDIT)<ref name="pmid20233780">{{cite journal| author=Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE et al.| title=2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. | journal=Circulation | year= 2010 | volume= 121 | issue= 13 | pages= e266-369 | pmid=20233780 | doi=10.1161/CIR.0b013e3181d4739e | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20233780 }} </ref>== | |||
===History and Physical Examination for Thoracic Aortic Disease (DO NOT EDIT)<ref name="pmid20233780">{{cite journal| author=Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE et al.| title=2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. | journal=Circulation | year= 2010 | volume= 121 | issue= 13 | pages= e266-369 | pmid=20233780 | doi=10.1161/CIR.0b013e3181d4739e | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20233780 }} </ref>=== | |||
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |||
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|bgcolor="LightGreen" |<nowiki>"</nowiki>'''1.''' For patients presenting with a history of acute cardiac and noncardiac symptoms associated with a significant likelihood of thoracic aortic disease, the clinician should perform a focused physical examination, including a careful and complete search for arterial perfusion differentials in both upper and lower extremities, evidence of visceral ischemia, focal neurological deficits, a [[murmur]] of [[aortic regurgitation]], [[bruit]]s, and findings compatible with possible [[cardiac tamponade]].<ref>Townsend CM, Beauchamp RD, Evers BM, et al. Sabiston Textbook of Surgery. 18th ed. Philadelphia: Elsevier Health Sciences, 2008.</ref><ref>Libby P, Bonow RO, Mann DL, et al. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia: 2007.</ref><ref>Isselbacher E. Cecil Medicine. 23rd ed. Philadelphia: Elsevier Health Sciences, 2008.</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
|} | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Disease]] | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Vascular surgery]] | [[Category:Vascular surgery]] | ||
Latest revision as of 21:09, 22 January 2020
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Thoracic aortic aneurysm Microchapters |
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Differentiating Thoracic Aortic Aneurysm from other Diseases |
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Diagnosis |
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Treatment |
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Special Scenarios |
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Case Studies |
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Thoracic aortic aneurysm physical examination On the Web |
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Directions to Hospitals Treating Thoracic aortic aneurysm physical examination |
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Risk calculators and risk factors for Thoracic aortic aneurysm physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohammad Salih, MD.
Overview
A large thoracic aortic aneurysm may be associated with findings on physical examination secondary to aortic insufficiency (wide pulse pressure, diastolic murmur, heart failure) and compression of adjacent structures such as the recurrent laryngeal nerve (hoarseness), superior vena cava obstruction (selling of the face and neck), and the airway (stridor and wheezing).
Physical Examination
General
The patient may be hoarse in the presence of an arch aneurysm due to compression of the recurrent laryngeal nerve.
Vitals
A widened pulse pressure may be present due to aortic insufficiency in the presence of an ascending aortic aneurysm.
Neck
Signs of superior vena cava obstruction such as a swollen face and neck may be present in the presence of an ascending aortic aneurysm.
Cardiac
Signs of aortic insufficiency and left ventricular heart failure may be present in the presence of an ascending aortic aneurysm.
Pulmonary
Stridor and wheezing may be present in the presence of a descending aorta aneurysm.
2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease (DO NOT EDIT)[1]
History and Physical Examination for Thoracic Aortic Disease (DO NOT EDIT)[1]
| Class I |
| "1. For patients presenting with a history of acute cardiac and noncardiac symptoms associated with a significant likelihood of thoracic aortic disease, the clinician should perform a focused physical examination, including a careful and complete search for arterial perfusion differentials in both upper and lower extremities, evidence of visceral ischemia, focal neurological deficits, a murmur of aortic regurgitation, bruits, and findings compatible with possible cardiac tamponade.[2][3][4] (Level of Evidence: C)" |
References
- ↑ 1.0 1.1 Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE; et al. (2010). "2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine". Circulation. 121 (13): e266–369. doi:10.1161/CIR.0b013e3181d4739e. PMID 20233780.
- ↑ Townsend CM, Beauchamp RD, Evers BM, et al. Sabiston Textbook of Surgery. 18th ed. Philadelphia: Elsevier Health Sciences, 2008.
- ↑ Libby P, Bonow RO, Mann DL, et al. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia: 2007.
- ↑ Isselbacher E. Cecil Medicine. 23rd ed. Philadelphia: Elsevier Health Sciences, 2008.