Atrial flutter physical examination: Difference between revisions

	Atrial flutter Microchapters
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Revision as of 15:44, 10 January 2020

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

Appearance of the Patient

Patients with atrial flutter usually appear normal.

Vital Signs

Tachycardia with regular pulse or irregular pulse
Low blood pressure with normal 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

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.
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.

References

Template:WH Template:WS

@@ Line 9: / Line 9: @@
 ==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====
-[[Heart sounds#Third heart sound S3|S3]] may be heard in congestive heart failure.  A mid-to-late systolic click is present, followed by a late systolic [[heart sounds|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].
+*Patients with atrial flutter usually appear normal.
 ===Vital Signs===
+*[[Tachycardia]] with regular pulse or irregular pulse
-*High-grade / low-grade fever
+*Low blood pressure with normal pulse pressure
-*[[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===
@@ Line 69: / Line 29: @@
 ===Heart===
-* Cardiovascular examination of patients with [disease name] is usually normal.
+*S3 may be heard in congestive heart failure.
-OR
+*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.
-*Chest tenderness upon palpation
+*Holosystolic murmur is heard in mitral regurgitation due to rheumatic heart disease.
-*PMI within 2 cm of the sternum  (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
-*[[Heave]] / [[thrill]]
-*[[Friction rub]]
-*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
-*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
-*[[Heart sounds#Third heart sound S3|S3]]
-*[[Heart sounds#Fourth heart sound S4|S4]]
-*[[Heart sounds#Summation Gallop|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===