Primary hyperaldosteronism physical examination: Difference between revisions
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== Overview == | == Overview == | ||
Patients with primary hyperaldosteronism usually appear well. Physical examination of patients with primary hyperaldosteronism is usually remarkable for high blood pressure, tachycardia, and an S4 maybe heard on auscultation of the precordium suggesting left ventricular hypertrophy secondary to increased afterload due to hypertension.__NOTOC__ | Patients with primary hyperaldosteronism usually appear well. Physical examination of patients with primary hyperaldosteronism is usually remarkable for high [[blood pressure]], [[tachycardia]], and an [[S4]] maybe heard on auscultation of the [[precordium]] suggesting [[left ventricular hypertrophy]] secondary to increased [[afterload]] due to [[hypertension]].__NOTOC__ | ||
{{Primary hyperaldosteronism}} | {{Primary hyperaldosteronism}} | ||
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=== Vital signs === | === Vital signs === | ||
* Normal body temperature | * Normal body temperature | ||
* [[Tachycardia]] with irregular pulse<ref name="pmid19946238">{{cite journal |vauthors=Zelinka T, Holaj R, Petrák O, Strauch B, Kasalický M, Hanus T, Melenovský V, Vancura V, Bürgelová M, Widimský J |title=Life-threatening arrhythmia caused by primary aldosteronism |journal=Med. Sci. Monit. |volume=15 |issue=12 |pages=CS174–7 |year=2009 |pmid=19946238 |doi= |url=}}</ref><ref name="pmid11045185">{{cite journal |vauthors=Pella J, Lazúrová I, Javorská B, Trejbal D |title=[Conn's syndrome and severe arrhythmias] |language=Slovak |journal=Vnitr Lek |volume=45 |issue=4 |pages=228–31 |year=1999 |pmid=11045185 |doi= |url=}}</ref> | * [[Tachycardia]] with [[irregular pulse]]<ref name="pmid19946238">{{cite journal |vauthors=Zelinka T, Holaj R, Petrák O, Strauch B, Kasalický M, Hanus T, Melenovský V, Vancura V, Bürgelová M, Widimský J |title=Life-threatening arrhythmia caused by primary aldosteronism |journal=Med. Sci. Monit. |volume=15 |issue=12 |pages=CS174–7 |year=2009 |pmid=19946238 |doi= |url=}}</ref><ref name="pmid11045185">{{cite journal |vauthors=Pella J, Lazúrová I, Javorská B, Trejbal D |title=[Conn's syndrome and severe arrhythmias] |language=Slovak |journal=Vnitr Lek |volume=45 |issue=4 |pages=228–31 |year=1999 |pmid=11045185 |doi= |url=}}</ref> | ||
* Normal respiratory rate | * Normal respiratory rate | ||
* | * High [[blood pressure]] may be the only presenting sign | ||
=== Skin === | === Skin === | ||
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=== Neck === | === Neck === | ||
* No lymphadenopathy | * No [[lymphadenopathy]] | ||
* No thyromegaly | * No [[thyromegaly]] | ||
* Elevated JVP | * Elevated [[Jugular venous pressure|JVP]] | ||
=== Lungs === | === Lungs === | ||
* Symmetric chest expansion | * Symmetric chest expansion | ||
* Normal breath sounds | * Normal breath sounds | ||
* No rales, rhochi and wheeze | * No [[rales]], rhochi and [[wheeze]] | ||
* [[Egophony]] absent | * [[Egophony]] absent | ||
* [[Bronchophony]] absent | * [[Bronchophony]] absent | ||
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* [[Heart sounds#First heart tone S1.2C the .22lub.22.28components M1 and T1.29|S1]] | * [[Heart sounds#First heart tone S1.2C the .22lub.22.28components M1 and T1.29|S1]] | ||
* [[Heart sounds#Second heart tone S2 the .22dub.22.28components A2 and P2.29|S2]] | * [[Heart sounds#Second heart tone S2 the .22dub.22.28components A2 and P2.29|S2]] | ||
* [[Heart sounds#Fourth heart sound S4|S4]] may be heard due to left ventricular hypertrophy<ref name="pmid15291171">{{cite journal |vauthors=du Cailar G |title=[Cardiac consequences of primary hyperaldosteronism] |language=French |journal=Ann Cardiol Angeiol (Paris) |volume=53 |issue=3 |pages=147–9 |year=2004 |pmid=15291171 |doi= |url= |issn=}}</ref> | * [[Heart sounds#Fourth heart sound S4|S4]] may be heard due to [[left ventricular hypertrophy]]<ref name="pmid15291171">{{cite journal |vauthors=du Cailar G |title=[Cardiac consequences of primary hyperaldosteronism] |language=French |journal=Ann Cardiol Angeiol (Paris) |volume=53 |issue=3 |pages=147–9 |year=2004 |pmid=15291171 |doi= |url= |issn=}}</ref> | ||
* No gallop rhythm | * No [[gallop rhythm]] | ||
* Ventricular fibrillation may be a finding in primary hyperaldosteronism<ref name="pmid19610566">{{cite journal |vauthors=Delgado Y, Quesada E, Pérez Arzola M, Bredy R |title=Ventricular fibrillation as the first manifestation of primary hyperaldosteronism |journal=Bol Asoc Med P R |volume=98 |issue=4 |pages=258–62 |year=2006 |pmid=19610566 |doi= |url= |issn=}}</ref> | * [[Ventricular fibrillation]] may be a finding in primary hyperaldosteronism<ref name="pmid19610566">{{cite journal |vauthors=Delgado Y, Quesada E, Pérez Arzola M, Bredy R |title=Ventricular fibrillation as the first manifestation of primary hyperaldosteronism |journal=Bol Asoc Med P R |volume=98 |issue=4 |pages=258–62 |year=2006 |pmid=19610566 |doi= |url= |issn=}}</ref> | ||
=== Abdomen === | === Abdomen === | ||
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* Non-distended | * Non-distended | ||
* No abnormal fluids or gas | * No abnormal fluids or gas | ||
* No palpable organomegaly | * No palpable [[organomegaly]] | ||
=== Back === | === Back === | ||
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=== Genitourinary === | === Genitourinary === | ||
* There are no abnormal genitourinary findings associated with primary hyperaldosteronism | * There are no abnormal [[Genitourinary system|genitourinary]] findings associated with primary hyperaldosteronism | ||
=== Extremities === | === Extremities === | ||
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=== Neurologic === | === Neurologic === | ||
* Hyperaldosteronism induced hypertension may lead to stroke and paralysis<ref name="pmid10023636">{{cite journal |vauthors=Nishimura M, Uzu T, Fujii T, Kuroda S, Nakamura S, Inenaga T, Kimura G |title=Cardiovascular complications in patients with primary aldosteronism |journal=Am. J. Kidney Dis. |volume=33 |issue=2 |pages=261–6 |year=1999 |pmid=10023636 |doi= |url= |issn=}}</ref> | * Hyperaldosteronism induced [[hypertension]] may lead to [[stroke]] and [[paralysis]]<ref name="pmid10023636">{{cite journal |vauthors=Nishimura M, Uzu T, Fujii T, Kuroda S, Nakamura S, Inenaga T, Kimura G |title=Cardiovascular complications in patients with primary aldosteronism |journal=Am. J. Kidney Dis. |volume=33 |issue=2 |pages=261–6 |year=1999 |pmid=10023636 |doi= |url= |issn=}}</ref> | ||
==References== | ==References== | ||
Revision as of 13:54, 24 July 2017
Overview
Patients with primary hyperaldosteronism usually appear well. Physical examination of patients with primary hyperaldosteronism is usually remarkable for high blood pressure, tachycardia, and an S4 maybe heard on auscultation of the precordium suggesting left ventricular hypertrophy secondary to increased afterload due to hypertension.
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Differentiating Primary Hyperaldosteronism from other Diseases |
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Primary hyperaldosteronism physical examination On the Web |
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Risk calculators and risk factors for Primary hyperaldosteronism physical examination |
Physical Examination
Appearance of the patient
- Patient is usually well-appearing
Vital signs
- Normal body temperature
- Tachycardia with irregular pulse[1][2]
- Normal respiratory rate
- High blood pressure may be the only presenting sign
Skin
- There are no abnormal skin findings associated with primary hyperaldosteronism
HEENT
- HEENT examination is normal in primary hyperaldosteronism.
Neck
- No lymphadenopathy
- No thyromegaly
- Elevated JVP
Lungs
- Symmetric chest expansion
- Normal breath sounds
- No rales, rhochi and wheeze
- Egophony absent
- Bronchophony absent
- Normal tactile fremitus
Heart
- No chest tenderness on palpation
- PMI within 2 cm of the sternum
- S1
- S2
- S4 may be heard due to left ventricular hypertrophy[3]
- No gallop rhythm
- Ventricular fibrillation may be a finding in primary hyperaldosteronism[4]
Abdomen
- Non-tender
- Non-distended
- No abnormal fluids or gas
- No palpable organomegaly
Back
- There are no abnormal findings on the back associated with primary hyperaldosteronism.
Genitourinary
- There are no abnormal genitourinary findings associated with primary hyperaldosteronism
Extremities
- Extremities are normal on examination in primary hyperaldosteronism
Neurologic
- Hyperaldosteronism induced hypertension may lead to stroke and paralysis[5]
References
- ↑ Zelinka T, Holaj R, Petrák O, Strauch B, Kasalický M, Hanus T, Melenovský V, Vancura V, Bürgelová M, Widimský J (2009). "Life-threatening arrhythmia caused by primary aldosteronism". Med. Sci. Monit. 15 (12): CS174–7. PMID 19946238.
- ↑ Pella J, Lazúrová I, Javorská B, Trejbal D (1999). "[Conn's syndrome and severe arrhythmias]". Vnitr Lek (in Slovak). 45 (4): 228–31. PMID 11045185.
- ↑ du Cailar G (2004). "[Cardiac consequences of primary hyperaldosteronism]". Ann Cardiol Angeiol (Paris) (in French). 53 (3): 147–9. PMID 15291171.
- ↑ Delgado Y, Quesada E, Pérez Arzola M, Bredy R (2006). "Ventricular fibrillation as the first manifestation of primary hyperaldosteronism". Bol Asoc Med P R. 98 (4): 258–62. PMID 19610566.
- ↑ Nishimura M, Uzu T, Fujii T, Kuroda S, Nakamura S, Inenaga T, Kimura G (1999). "Cardiovascular complications in patients with primary aldosteronism". Am. J. Kidney Dis. 33 (2): 261–6. PMID 10023636.