Non-bacterial thrombotic endocarditis physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Non-bacterial thrombotic endocarditis}} | {{Non-bacterial thrombotic endocarditis}} | ||
{{CMG}}; {{AE}}{{Aisha}} | {{CMG}}; {{AE}}{{Aisha}}[[User:Sara Mohsin|Sara Mohsin, M.D.]] | ||
==Overview== | ==Overview== | ||
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3]. | Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3]. | ||
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==Physical Examination== | ==Physical Examination== | ||
There are no specific findings for non-bacterial thrombotic endocarditis. Patients with NBTE may show signs of systemic thromboembolism, cardiac dysfunction, and underlying diseases. | There are no specific findings for [[non-bacterial thrombotic endocarditis]]. Patients with NBTE may show signs of systemic thromboembolism, cardiac dysfunction, and underlying diseases. | ||
===General appearance=== | ===General appearance=== | ||
*Patients with NBTE usually appear non-toxic. Patients may present with acute signs of cerebral or systemic embolisms of signs or cardiac dysfunction. | *Patients with NBTE usually appear non-toxic. Patients may present with acute signs of cerebral or systemic [[Embolism|embolisms]] of signs or [[cardiac dysfunction]]. | ||
===Vital Signs=== | ===Vital Signs=== | ||
*Fever (if due to malignancy or complicated by secondary infectious endocarditis | *[[Fever]] (if due to [[malignancy]] or complicated by secondary [[infectious endocarditis]]) | ||
*Hypotension (if severe left ventricular dysfunction is present) | *[[Hypotension]] (if severe [[left ventricular dysfunction]] is present) | ||
*[[Tachycardia]] | *[[Tachycardia]] | ||
*Tachypnea | *[[Tachypnea]] | ||
*Orthopnea | *[[Orthopnea]] | ||
===Skin=== | ===Skin=== | ||
*Raynaud's phenomenon ( | *[[Raynaud's phenomenon]] (in the case of [[Embolism|peripheral embolism]]) | ||
*Malar rash (in patients with SLE) | *[[Malar rash]] (in patients with [[Systemic lupus erythematosus|SLE]]) | ||
===HEENT=== | ===HEENT=== | ||
* HEENT examination of patients with NBTE is usually normal. | * HEENT examination of patients with [[Non-bacterial thrombotic endocarditis|NBTE]] is usually normal. | ||
===Neck=== | ===Neck=== | ||
*[[Jugular venous distension]] may be noted secondary to heart failure due to valvular dysfunction | *[[Jugular venous distension]] may be noted secondary to [[Congestive heart failure|heart failure]] due to [[Valvular heart disease|valvular dysfunction]] | ||
*[[Lymphadenopathy]] (in the case of malignancy) | *[[Lymphadenopathy]] (in the case of malignancy) | ||
===Lungs=== | ===Lungs=== | ||
*lung fields may be dull on percussion in the presence of secondary infection, or pleural effusion due to malignancy | *lung fields may be dull on [[percussion]] in the presence of secondary [[infection]], or [[pleural effusion]] due to malignancy | ||
===Heart=== | ===Heart=== | ||
Left ventricular hypertrophy due to aortic or mitral valve disease can present as any of the following | Left ventricular hypertrophy due to aortic or mitral valve disease can present as any of the following | ||
* Displacement of apex beat | |||
* Enlarged and sustained apical impulse | |||
* S4 | |||
* S2 (due to aortic root dilatation) | |||
===Abdomen=== | ===Abdomen=== | ||
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*[[Clubbing]] may be seen in patients with malignancies | *[[Clubbing]] may be seen in patients with malignancies | ||
*[[Cyanosis]] due to peripheral embolism | *[[Cyanosis]] due to peripheral embolism | ||
*Pedal edema may be observed if heart failure is present | *[[Pedal edema]] may be observed if heart failure is present | ||
*Polyarthralgia and arthritis may be observed | *[[Polyarthralgia]] and [[arthritis]] may be observed | ||
{| class="wikitable" | {| class="wikitable" | ||
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!style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Physical examination finding}} | !style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Physical examination finding}} | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Left ventricular hypertrophy]] | |style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Left ventricular hypertrophy]] | ||
|[[Left ventricular hypertrophy|LVH]] can [[Presenting symptom|present]] as any of the following: | |[[Left ventricular hypertrophy|LVH]] can [[Presenting symptom|present]] as any of the following: | ||
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*[[Rales]] on [[lung examination]] | *[[Rales]] on [[lung examination]] | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Secondary infective endocarditis]] ([[IE]]) | |style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Secondary infective endocarditis]] ([[IE]]) | ||
|[[Infective endocarditis|IE]] can [[Presenting symptom|present]] as: | |[[Infective endocarditis|IE]] can [[Presenting symptom|present]] as: | ||
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*[[Back pain]] (due to [[vertebral osteomyelitis]]) | *[[Back pain]] (due to [[vertebral osteomyelitis]]) | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Mitral valve disease]] | |style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Mitral valve disease]] | ||
| | | | ||
* High-[[Pitch|pitched]] “blowing” [[holosystolic murmur]] of '''[[mitral regurgitation]]''' (more common) which is best [[Hearing|heard]] at the [[apex of the heart]] with the [[patient]] in left [[lateral]] [[decubitus]] [[Position effect|position]]. | * High-[[Pitch|pitched]] “blowing” [[holosystolic murmur]] of '''[[mitral regurgitation]]''' (more common) which is best [[Hearing|heard]] at the [[apex of the heart]] with the [[patient]] in left [[lateral]] [[decubitus]] [[Position effect|position]]. | ||
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{{WS}} | {{WS}} | ||
[[Category: (name of the system)]] | [[Category: (name of the system)]] | ||
<references /> | |||
Revision as of 17:20, 16 August 2020
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non-bacterial thrombotic endocarditis |
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Differentiating non-bacterial thrombotic endocarditis from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Non-bacterial thrombotic endocarditis physical examination On the Web |
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American Roentgen Ray Society Images of Non-bacterial thrombotic endocarditis physical examination |
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FDA on Non-bacterial thrombotic endocarditis physical examination |
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CDC on Non-bacterial thrombotic endocarditis physical examination |
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Non-bacterial thrombotic endocarditis physical examination in the news |
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Blogs on Non-bacterial thrombotic endocarditis physical examination |
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Risk calculators and risk factors for Non-bacterial thrombotic endocarditis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]Sara Mohsin, M.D.
Overview
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
OR
Common physical examination findings of [disease name] include [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].
Physical Examination
There are no specific findings for non-bacterial thrombotic endocarditis. Patients with NBTE may show signs of systemic thromboembolism, cardiac dysfunction, and underlying diseases.
General appearance
- Patients with NBTE usually appear non-toxic. Patients may present with acute signs of cerebral or systemic embolisms of signs or cardiac dysfunction.
Vital Signs
- Fever (if due to malignancy or complicated by secondary infectious endocarditis)
- Hypotension (if severe left ventricular dysfunction is present)
- Tachycardia
- Tachypnea
- Orthopnea
Skin
- Raynaud's phenomenon (in the case of peripheral embolism)
- Malar rash (in patients with SLE)
HEENT
- HEENT examination of patients with NBTE is usually normal.
Neck
- Jugular venous distension may be noted secondary to heart failure due to valvular dysfunction
- Lymphadenopathy (in the case of malignancy)
Lungs
- lung fields may be dull on percussion in the presence of secondary infection, or pleural effusion due to malignancy
Heart
Left ventricular hypertrophy due to aortic or mitral valve disease can present as any of the following
- Displacement of apex beat
- Enlarged and sustained apical impulse
- S4
- S2 (due to aortic root dilatation)
Abdomen
- Abdominal distension
- Abdominal pain/tenderness in the left upper quadrant due to splenic embolism
- Flank pain
- Ascites may be observed in cases of heart failure and fluid overload
Genitourinary
- Genitourinary examination of patients with NBTE is usually normal
Extremities
- Clubbing may be seen in patients with malignancies
- Cyanosis due to peripheral embolism
- Pedal edema may be observed if heart failure is present
- Polyarthralgia and arthritis may be observed