Alpha 1-antitrypsin deficiency physical examination: Difference between revisions
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==Overview== | ==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]] of [[patients]] with AATD is usually remarkable for signs that are characteristic of increased [[respiratory]] work, airflow obstruction and hyperinflation that varies according to the severity of [[emphysema]]. Patients with [[Emphysema|mild emphysema]] usually have no abnormal findings on [[physical examination]]. [[Patient]] may appear normal on [[physical examination]] .Those with severe [[emphysema]] develop [[tachypnea]] and pursed-lip breathing. Other findings on [[physical examination]] include [[pulsus paradoxus]], [[scalene muscle]] retraction, [[Intercostal muscles|intercostal muscle]] retraction, [[wheezing]], [[hepatomegaly]], hyperinflation results in [[barrel chest]], increased [[Percussion|percussion note]], decreased [[Breath sounds|breath sound]] intensity, distant [[heart sounds]]. | ||
==Physical Examination== | ==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.<ref name="pmid3257661">{{cite journal |vauthors=Cox DW, Levison H |title=Emphysema of early onset associated with a complete deficiency of alpha-1-antitrypsin (null homozygotes) |journal=Am. Rev. Respir. Dis. |volume=137 |issue=2 |pages=371–5 |year=1988 |pmid=3257661 |doi=10.1164/ajrccm/137.2.371 |url=}}</ref><ref name="pmid8970361">{{cite journal |vauthors=Turino GM, Barker AF, Brantly ML, Cohen AB, Connelly RP, Crystal RG, Eden E, Schluchter MD, Stoller JK |title=Clinical features of individuals with PI*SZ phenotype of alpha 1-antitrypsin deficiency. alpha 1-Antitrypsin Deficiency Registry Study Group |journal=Am. J. Respir. Crit. Care Med. |volume=154 |issue=6 Pt 1 |pages=1718–25 |year=1996 |pmid=8970361 |doi=10.1164/ajrccm.154.6.8970361 |url=}}</ref> | [[Physical examination]] of [[patients]] with AATD is usually remarkable for signs characteristic of [[Respiratory Physiology|increased respiratory work]], airflow obstruction and hyperinflation that varies according to the severity of [[emphysema]].<ref name="pmid3257661">{{cite journal |vauthors=Cox DW, Levison H |title=Emphysema of early onset associated with a complete deficiency of alpha-1-antitrypsin (null homozygotes) |journal=Am. Rev. Respir. Dis. |volume=137 |issue=2 |pages=371–5 |year=1988 |pmid=3257661 |doi=10.1164/ajrccm/137.2.371 |url=}}</ref><ref name="pmid8970361">{{cite journal |vauthors=Turino GM, Barker AF, Brantly ML, Cohen AB, Connelly RP, Crystal RG, Eden E, Schluchter MD, Stoller JK |title=Clinical features of individuals with PI*SZ phenotype of alpha 1-antitrypsin deficiency. alpha 1-Antitrypsin Deficiency Registry Study Group |journal=Am. J. Respir. Crit. Care Med. |volume=154 |issue=6 Pt 1 |pages=1718–25 |year=1996 |pmid=8970361 |doi=10.1164/ajrccm.154.6.8970361 |url=}}</ref> | ||
Patients with mild emphysema usually have no abnormal findings on physical examination. | |||
[[Patients]] with mild [[emphysema]] usually have no abnormal findings on [[physical examination]]. | |||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
Patient may appear normal. | Patient may appear normal.Those with severe [[emphysema]] develop [[tachypnea]] and pursed-lip breathing. | ||
Those with severe emphysema develop tachypnea and pursed-lip breathing. | |||
===Vital Signs=== | ===Vital Signs=== | ||
Pulsus paradoxus | [[Pulsus paradoxus]] | ||
===Neck=== | ===Neck=== | ||
Scalene muscle retraction | [[Scalene muscles|Scalene muscle retraction]] | ||
===Thorax=== | ===Thorax=== | ||
*Intercostal muscle retraction | *[[Intercostal muscles|Intercostal muscle retraction]] | ||
*Wheezing | *[[Wheezing]] | ||
*Hyperinflation results in : | *Hyperinflation results in : | ||
* | *[[Barrel chest]] | ||
* | *Increased [[Percussion|percussion note]] | ||
* | *Decreased [[Breath sounds|breath sound]] intensity | ||
* | *Distant [[heart sounds]]. | ||
===Abdomen=== | ===Abdomen=== | ||
Hepatomegaly | [[Hepatomegaly]] | ||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]
Overview
Physical examination of patients with AATD is usually remarkable for signs that are 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 on physical examination .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.[1][2]
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
Neck
Thorax
- Intercostal muscle retraction
- Wheezing
- Hyperinflation results in :
- Barrel chest
- Increased percussion note
- Decreased breath sound intensity
- Distant heart sounds.
Abdomen
References
- ↑ Cox DW, Levison H (1988). "Emphysema of early onset associated with a complete deficiency of alpha-1-antitrypsin (null homozygotes)". Am. Rev. Respir. Dis. 137 (2): 371–5. doi:10.1164/ajrccm/137.2.371. PMID 3257661.
- ↑ Turino GM, Barker AF, Brantly ML, Cohen AB, Connelly RP, Crystal RG, Eden E, Schluchter MD, Stoller JK (1996). "Clinical features of individuals with PI*SZ phenotype of alpha 1-antitrypsin deficiency. alpha 1-Antitrypsin Deficiency Registry Study Group". Am. J. Respir. Crit. Care Med. 154 (6 Pt 1): 1718–25. doi:10.1164/ajrccm.154.6.8970361. PMID 8970361.