Alpha 1-antitrypsin deficiency physical examination

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

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Overview

Physical examination of patients with AATD is usually remarkable for signs characteristic of increased respiratory work,airflow obstruction and hyperinflation that varies according to the severity of emphysema.Patients with mild emphysema usually have no abnormal findings on physical examination.Patient may appear normal.Those with severe emphysema develop tachypnea and pursed-lip breathing. Other findings on physical examination include pulsus paradoxus,scalene muscle retraction,intercostal muscle retraction,wheezing,hepatomegaly,hyperinflation results in barrel chest,increased percussion note,decreased breath sound intensity,distant heart sounds.

Physical Examination

Physical examination of patients with AATD is usually remarkable for signs characteristic of increased respiratory work,airflow obstruction and hyperinflation that varies according to the severity of emphysema. Patients with mild emphysema usually have no abnormal findings on physical examination.

Appearance of the Patient

Patient may appear normal. Those with severe emphysema develop tachypnea and pursed-lip breathing.

Vital Signs

Pulsus paradoxus

Neck

Scalene muscle retraction

Thorax

• Intercostal muscle retraction
• Wheezing
• Hyperinflation results in :
• barrel chest
• increased percussion note
• decreased breath sound intensity
• distant heart sounds.

Abdomen

Hepatomegaly

References

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