Eisenmenger’s syndrome physical examination: Difference between revisions

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{{CMG}}; {{AE}}{{AIA}}
{{CMG}}; {{AE}}{{AIA}}
==Overview==
==Overview==
The general examination of patients with Eisenmenger's syndrome may show [[cyanosis]], dermal changes, [[clubbing]], [[peripheral edema]], and abdominal swelling. Cardiac examination may show [[A wave]] dominant [[Jugular venous pressure|jugular venous pulse]], right ventricular [[heave]], high-pitched early diastolic [[Heart murmur|murmur]] of [[pulmonary insufficiency]], right-sided [[S4]], pulmonary ejection click, single palpable [[S2|S<sub>2</sub>]], and loud [[P2|P<sub>2</sub>]].


==Physical Examination==
==Physical Examination==
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=== Appearance of the Patient ===
=== Appearance of the Patient ===


* Patients with Eisenmenger's syndrome usually appear [general appearance].
* Patients with [[Eisenmenger's syndrome]] usually appear lethargic and cyanotic.


=== Vital Signs ===
=== Vital Signs ===


* [[Tachycardia]] with regular pulse or (ir)regularly irregular pulse
* [[Tachycardia]]  
* Tachypnea / bradypnea
* Tachypnea  
* Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
*[[Postural hypotension]]
* High/low blood pressure with normal pulse pressure / [[wide pulse pressure]] / [[narrow pulse pressure]]


=== Skin ===
=== Skin ===
Skin examination of patients with Eisenmenger's syndrome usually shows
Skin examination of patients with Eisenmenger's syndrome usually shows:


*[[Plethora]]  
*[[Plethora]]  
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* [[Jugular venous distension]]
* [[Jugular venous distension]]
* [[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
* [[Hepatojugular reflux]]
* [[Hepatojugular reflux]]


=== Lungs ===
=== Lungs ===


* Pulmonary examination of patients with [disease name] is usually normal.
* Pulmonary examination of patients with [[Eisenmenger's syndrome]] is usually normal.


===Heart===
===Heart===
* Jugular venous pressure may be raised with 'a' wave indicating increased right atrial pressure. A 'v' wave indicating development of tricuspid regurgitation may also be seen
 
* Right ventricular heave and thrill
* [[Jugular venous pressure|Jugular venous pulse]] wave may be [[A wave]] dominant
* Murmurs of tricuspid and pulmonic regurgitation maybe audible.
* Precordial palpation reveals a right ventricular [[heave]]
* Loud P2
* High-pitched early diastolic [[Heart murmur|murmur]] of [[pulmonary insufficiency]]
* Ejection click
* Right-sided [[S4]]
* Pulmonary ejection click
* Single palpable [[S2|S<sub>2</sub>]]
* Loud [[P2|P<sub>2</sub>]]


===Abdomen===
===Abdomen===
* [[Hepatomegaly]]
* [[Hepatomegaly]]
* [[Ascites]]
*[[Jaundice]]
*Right upper abdominal quadrant [[tenderness]]


=== Back ===
=== Back ===


* Back examination of patients with Eisenmenger's syndrome is usually normal.
* Back examination of patients with [[Eisenmenger's syndrome]] is usually normal.


=== Genitourinary ===
=== Genitourinary ===


* Genitourinary examination of patients with Eisenmenger's syndrome is usually normal.
* Genitourinary examination of patients with [[Eisenmenger's syndrome]] is usually normal.


=== Neuromuscular ===
=== Neuromuscular ===


* Neuromuscular examination of patients with Eisenmenger's syndrome is usually normal.
* Neuromuscular examination of patients with [[Eisenmenger's syndrome]] is usually normal.


===Extremities===
===Extremities===

Revision as of 14:28, 20 January 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdelrahman Ibrahim Abushouk, MD[2]

Overview

The general examination of patients with Eisenmenger's syndrome may show cyanosis, dermal changes, clubbing, peripheral edema, and abdominal swelling. Cardiac examination may show A wave dominant jugular venous pulse, right ventricular heave, high-pitched early diastolic murmur of pulmonary insufficiency, right-sided S4, pulmonary ejection click, single palpable S2, and loud P2.

Physical Examination

Appearance of the Patient

Vital Signs

Skin

Skin examination of patients with Eisenmenger's syndrome usually shows:

HEENT

  • HEENT examination of patients with Eisenmenger's syndrome is usually normal.

Neck

Lungs

Heart

Abdomen

Back

Genitourinary

Neuromuscular

Extremities

References

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