Syncope physical examination: Difference between revisions
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Patients with syncope usually appear normal. Physical examination of patients with syncope is usually remarkable for [[cardiac]] [[murmur]], [[orthostatic hypotension]], and altered level of consciousness. | Patients with syncope usually appear normal. Physical examination of patients with syncope is usually remarkable for [[cardiac]] [[murmur]], [[orthostatic hypotension]], and altered level of consciousness. | ||
==Physical Examination== | ==Physical Examination== | ||
Patients with syncope usually appear normal. | [[Patients]] with syncope usually appear normal. | ||
Physical examination of patients with syncope is usually remarkable for [[cardiac]] [[murmur]], [[orthostatic hypotension]], and altered level of consciousness. | Physical examination of [[patients]] with syncope is usually remarkable for [[cardiac]] [[murmur]], [[orthostatic hypotension]], and altered level of consciousness. | ||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
*Patients with Syncope usually appear normal. | *[[Patients]] with Syncope usually appear normal. | ||
===Vital Signs=== | ===Vital Signs=== | ||
*[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse may be present in the case, [[structural heart disease]] is the underlying cause of syncope. | *[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse may be present in the case, [[structural heart disease]] is the underlying cause of syncope. | ||
*[[Bradycardia]] with regular pulse or (ir)regularly irregular pulse may be present in the case, | *[[Bradycardia]] with regular pulse or (ir)regularly irregular pulse may be present in the case, conductive heart problems is the underlying cause of syncope. | ||
*[[Orthostatic hypotension]] may be present. | *[[Orthostatic hypotension]] may be present. | ||
===Skin=== | ===Skin=== | ||
Skin examination of patients with syncope is usually normal. However, it may be remarkable for: | [[Skin]] examination of [[patients]] with syncope is usually normal. However, it may be remarkable for: | ||
*[[Cyanosis]] | *[[Cyanosis]] | ||
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===HEENT=== | ===HEENT=== | ||
* HEENT examination of patients with syncope is usually normal. | * HEENT examination of [[patients]] with syncope is usually normal. | ||
===Neck=== | ===Neck=== | ||
Neck examination of patients with syncope is usually normal. However, it may be remarkable for the following findings depending on the underlying cause of syncope: | Neck examination of [[patients]] with syncope is usually normal. However, it may be remarkable for the following findings depending on the underlying cause of syncope: | ||
*[[Jugular venous distension]] | *[[Jugular venous distension]] | ||
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===Lungs=== | ===Lungs=== | ||
* Pulmonary examination of patients with syncope is usually normal. | *[[Pulmonary]] examination of [[patients]] with syncope is usually normal. | ||
===Heart=== | ===Heart=== | ||
Cardiovascular examination of patients with syncope is usually normal. However, if the underlying cause of the syncope is cardiovascular disease, it may be remarkable for: | [[Cardiovascular]] examination of [[patients]] with syncope is usually normal. However, if the underlying cause of the syncope is [[cardiovascular disease]], it may be remarkable for: | ||
*[[Heave]] / [[thrill]] | *[[Heave]] / [[thrill]] | ||
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*[[Heart sounds#Fourth heart sound S4|S4]] | *[[Heart sounds#Fourth heart sound S4|S4]] | ||
*[[Heart sounds#Summation Gallop|Gallops]] | *[[Heart sounds#Summation Gallop|Gallops]] | ||
*A murmur may be heard using the stethoscope. | *A [[heart murmur]] may be heard using the stethoscope. | ||
===Abdomen=== | ===Abdomen=== | ||
* Abdominal examination of patients with syncope is usually normal. | *[[Abdominal]] examination of [[patients]] with syncope is usually normal. | ||
===Genitourinary=== | ===Genitourinary=== | ||
* Genitourinary examination of patients with syncope is usually normal. | *[[Genitourinary]] examination of [[patients]] with syncope is usually normal. | ||
===Neuromuscular=== | ===Neuromuscular=== | ||
Neuromuscular examination of patients with syncope is usually normal. However, focal neurologic signs may be present if cerebrovascular events were misdiagnosed for syncope. These findings may include: | Neuromuscular examination of [[patients]] with syncope is usually normal. However, focal neurologic signs may be present if cerebrovascular events were misdiagnosed for syncope. These findings may include: | ||
* Altered mental status | *[[Altered mental status]] | ||
* Hyperreflexia | * Hyperreflexia | ||
* Positive (abnormal) Babinski | * Positive (abnormal) [[Babinski's sign|Babinski]] | ||
* Muscle rigidity | *[[Muscle rigidity]] | ||
* Proximal/distal muscle weakness unilaterally/bilaterally | * Proximal/distal [[muscle weakness]] unilaterally/bilaterally | ||
*Unilateral/bilateral upper/lower extremity weakness | *Unilateral/bilateral upper/lower extremity weakness | ||
* | *[[Dysdiadochokinesia]] (palm tapping test) | ||
===Extremities=== | ===Extremities=== | ||
Extremities examination of patients with syncope is usually normal. It may be remarkable for the following findings depending on the underlying cause: | Extremities examination of [[patients]] with syncope is usually normal. It may be remarkable for the following findings depending on the underlying cause: | ||
*[[Clubbing]] | *[[Clubbing]] | ||
Revision as of 19:34, 9 May 2020
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Syncope Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Syncope physical examination On the Web |
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American Roentgen Ray Society Images of Syncope physical examination |
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Risk calculators and risk factors for Syncope physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2]
Overview
Patients with syncope usually appear normal. Physical examination of patients with syncope is usually remarkable for cardiac murmur, orthostatic hypotension, and altered level of consciousness.
Physical Examination
Patients with syncope usually appear normal.
Physical examination of patients with syncope is usually remarkable for cardiac murmur, orthostatic hypotension, and altered level of consciousness.
Appearance of the Patient
- Patients with Syncope usually appear normal.
Vital Signs
- Tachycardia with regular pulse or (ir)regularly irregular pulse may be present in the case, structural heart disease is the underlying cause of syncope.
- Bradycardia with regular pulse or (ir)regularly irregular pulse may be present in the case, conductive heart problems is the underlying cause of syncope.
- Orthostatic hypotension may be present.
Skin
Skin examination of patients with syncope is usually normal. However, it may be remarkable for:
HEENT
- HEENT examination of patients with syncope is usually normal.
Neck
Neck examination of patients with syncope is usually normal. However, it may be remarkable for the following findings depending on the underlying cause of syncope:
- Jugular venous distension
- Carotid bruits may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope.
- Hepatojugular reflux
Lungs
Heart
Cardiovascular examination of patients with syncope is usually normal. However, if the underlying cause of the syncope is cardiovascular disease, it may be remarkable for:
Abdomen
Genitourinary
- Genitourinary examination of patients with syncope is usually normal.
Neuromuscular
Neuromuscular examination of patients with syncope is usually normal. However, focal neurologic signs may be present if cerebrovascular events were misdiagnosed for syncope. These findings may include:
- Altered mental status
- Hyperreflexia
- Positive (abnormal) Babinski
- Muscle rigidity
- Proximal/distal muscle weakness unilaterally/bilaterally
- Unilateral/bilateral upper/lower extremity weakness
- Dysdiadochokinesia (palm tapping test)
Extremities
Extremities examination of patients with syncope is usually normal. It may be remarkable for the following findings depending on the underlying cause: