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! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center; " | Physical examination
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center; " | Physical examination
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! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center; " | Lab Findings
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center; " | ECG
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging
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! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Signs & Symptoms
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Signs & Symptoms
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Murmur Type
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Murmur Type
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |ECG
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CXR
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Echocardiogram
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Echocardiogram
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Chest X-Ray
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Aortic Stenosis
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Aortic Stenosis
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** heard best at the base
** heard best at the base
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'''Left ventricular hypertrophy''':
* Wide QRS complex (especially in leads V1-V6)
* ST depression in leads V5-V6
* Left axis deviation
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*** hand grip
*** hand grip
*** rapid squatting
*** rapid squatting
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| style="background: #F5F5F5; padding: 5px;" |'''Left ventricular hypertrophy''':
 
* Wide QRS complex (especially in leads V1-V6)
* ST depression in leads V5-V6
* Left axis deviation
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** the time between A2 and OS is inversely correlated with severity  
** the time between A2 and OS is inversely correlated with severity  
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* [[P mitrale]]
* [[Atrial fibrillation]]: No P waves and irregularly irregular rhythm
* [[Right axis deviation]]
* Right ventricular hypertropy: Dominant R wave in V1 and V2
<br />
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*** rapid squatting
*** rapid squatting
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* [[P mitrale]] in lead II
* Increased QRS voltage
* [[Right axis deviation]]
* [[Atrial fibrillation]]
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Revision as of 17:03, 27 July 2020

Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
History Physical examination
ECG Imaging
Etiology Signs & Symptoms Murmur Type CXR Echocardiogram
Aortic Stenosis
  • Age-related calcification in the elderly
  • Bicuspid aortic valve in the young
    • leads to early calcification of the valve
  • Chest pain
  • Dyspnea on exertion
  • Palpitations
  • Symptoms of heart failure


Systolic murmur

  • crescendo-decrescendo murmur
    • radiates to the carotids
    • heard best at the base


Left ventricular hypertrophy:

  • Wide QRS complex (especially in leads V1-V6)
  • ST depression in leads V5-V6
  • Left axis deviation
Aortic Regurgitation
  • Aortic root dilatation
  • Bicuspid aortic valve
  • Endocarditis
  • Rheumatic fever
  • Diastolic murmur
    • early diastolic decrescendo murmur
    • Austin Flint murmur
      • apical diastolic rumbling
  • Maneuvers
    • ↑ murmur intensity
      • hand grip
      • rapid squatting
Left ventricular hypertrophy:
  • Wide QRS complex (especially in leads V1-V6)
  • ST depression in leads V5-V6
  • Left axis deviation
Mitral Stenosis
  • Rheumatic fever


Diastolic murmur

  • open snap (OS) and delayed rumbling mid-to-late diastolic murmur
    • the time between A2 and OS is inversely correlated with severity
  • Right ventricular hypertropy: Dominant R wave in V1 and V2


Mitral Regurgitation
  • Rheumatic fever
  • Endocarditis
  • Post-myocardial infarction
    • rupture of the chordae or papillary muscles  
  • Left ventricular dilatation
  • Symptoms of heart failure in severe cases
  • Holosystolic murmur
    • high-pitched and radiates towards the axilla
    • heard best at the apex
  • Maneuvers
    • ↑ murmur intensity
      • hand grip
      • rapid squatting

References

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