Atrial flutter physical examination: Difference between revisions
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Revision as of 20:25, 18 December 2019
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Atrial flutter Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
The patient should first be assessed for hemodynamic instability. The patient should also be examined for the presence of reversible causes of atrial flutter.
Physical Examination
Vitals
Temperature
Fever may be present.
Pulse
Pulse is usually rapid and may be regular or irregular. Ventricular rate is around 150 beats per minute because of 2:1 conduction. 1:1 ventricular conduction is fatal.
Blood pressure
Hypertension may be present.
Head and Neck
Exophthalmos and neck swelling can be seen in hyperthyroidism.
Heart
Auscultation
S3 may be heard in congestive heart failure. A mid-to-late systolic click is present, followed by a late systolic murmur which is best heard at the cardiac apex is observed in mitral valve prolapse. Similarly a holosystolic murmur is heard in mitral regurgitation due to rheumatic heart disease.
Physical examination of patients with [disease name] is usually normal.
OR
Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
OR
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
Appearance of the Patient
- Patients with [disease name] usually appear [general appearance].
Vital Signs
- High-grade / low-grade fever
- Hypothermia / hyperthermia may be present
- Tachycardia with regular pulse or (ir)regularly irregular pulse
- Bradycardia with regular pulse or (ir)regularly irregular pulse
- Tachypnea / bradypnea
- Kussmal respirations may be present in _____ (advanced disease state)
- Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
- High/low blood pressure with normal pulse pressure / wide pulse pressure / narrow pulse pressure
Skin
- Skin examination of patients with atrial flutter is usually normal.
HEENT
- Exophthalmos and neck swelling can be seen in hyperthyroidism.
Neck
- Neck examination of patients with atrial flutter is usually normal.
Lungs
- Pulmonary examination of patients with atrial flutter is usually normal.
Heart
- Cardiovascular examination of patients with [disease name] is usually normal.
OR
- Chest tenderness upon palpation
- PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
- Heave / thrill
- Friction rub
- S1
- S2
- S3
- 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
- S3 may be heard in congestive heart failure. A mid-to-late systolic click is present, followed by a late systolic murmur which is best heard at the cardiac apex is observed in mitral valve prolapse. Similarly a holosystolic murmur is heard in mitral regurgitation due to rheumatic heart disease.
Abdomen
- Abdominal examination of patients with atrial flutter is usually normal.
Back
- Back examination of patients with atrial flutter is usually normal.
Genitourinary
- Genitourinary examination of patients with atrial flutter is usually normal.
Neuromuscular
- Neuromuscular examination of patients with atrial flutter is usually normal.
Extremities
- Extremities examination of patients with atrial flutter is usually normal.