Chest pain physical examination: Difference between revisions
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* Temperature ([[pericarditis]], [[pleuritis]], [[fever]] can precipitate ischemic attacks) | * Temperature ([[pericarditis]], [[pleuritis]], [[fever]] can precipitate ischemic attacks) | ||
* Absent or decreased pulses in limbs ([[aortic dissection]] all four limbs), [[tachycardia]] ([[pulmonary embolism]]) | * Absent or decreased pulses in limbs ([[aortic dissection]] all four limbs), [[tachycardia]] ([[pulmonary embolism]]) | ||
* Blood pressure in both the arms (aortic dissection) | * Blood pressure in both the arms ([[aortic dissection]]) | ||
===Neck=== | ===Neck=== | ||
* Elevated [[jugular venous pulse]] | * Elevated [[jugular venous pulse]] | ||
Revision as of 16:03, 26 February 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Physical examination should focus on evaluating for the life-threatening causes of chest pain first. A complete physical exam should be done, which includes a thorough cardiac, lung, and abdominal exam.
Physical Examination
Vitals
- Temperature (pericarditis, pleuritis, fever can precipitate ischemic attacks)
- Absent or decreased pulses in limbs (aortic dissection all four limbs), tachycardia (pulmonary embolism)
- Blood pressure in both the arms (aortic dissection)
Neck
- Elevated jugular venous pulse
Cardiovascular
- Auscultation
- Third and fourth heart sound
- Carotid bruit
- Pericardial rub (pericarditis)
- Murmur (systolic murmur in hypertrophic cardiomyopathy, aortic stenosis)
Pulmonary
- Palpation - shift in trachea from midline (tension pneumothorax)
- Auscultation - decreased breath sound (pulmonary edema), pleural rub (pleuritis, pneumonia)
Gastrointestinal
- Inspection, palpation and auscultation to evaluate for gastrointestinal etiologies of chest pain
- Rectal examination - occult bleeding (peptic ulcers)