Pulmonary edema physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Patients with pulmonary edema usually appear agitated.Physical examination of patients with pulmonary edema is usually remarkable for | Patients with pulmonary edema usually appear agitated. Physical examination of patients with pulmonary edema is usually remarkable for [[dyspnea]], [[tachypnea]]. | ||
==Physical Examination== | ==Physical Examination== |
Revision as of 20:10, 22 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farnaz Khalighinejad, MD [2]
Overview
Patients with pulmonary edema usually appear agitated. Physical examination of patients with pulmonary edema is usually remarkable for dyspnea, tachypnea.
Physical Examination
Physical examination of patients with pulmonary edema is usually remarkable for:[1]
Clinical examination | |||||
---|---|---|---|---|---|
Cardiogenic pulmonary edema | Low flow state=cool periphery | S3 gallop/cardiomegaly | Jugular venous distention | Crackles(wet) | |
Noncardiogenic pulmonary edema | High flow state=warm periphery | No gallop | No jugular venous distention | Crackles(dry) |
Appearance of the Patient
- Patients with pulmonary edema usually appear :
- Anxious
- Decrease in level of alertness (consciousness)
- Inability to speak in full sentences
Vital Signs
- Hyperthermia may be present
- Tachycardia with regular pulse
- Tachypnea
- High/low blood pressure with normal pulse pressure
Skin
- Pallor
- cold and clammy
- livedo reticularis
- Peripheral cyanosis may be present
HEENT
- Nasal flaring
- Dilated alae nasi
Neck
- Neck examination of patients with pulmonary edema is usually normal.
Lungs
- Wheezing may be present
- Prolonged expiratory phase
- Retraction of intercostal muscle
- Use of accessory muscles of respiration
Heart
- A third heart sound (S3) may be present
- Pulsus alternans
- Alternating weak and strong pulse, may be a sign of left ventricular failure in CHF as underlying cause of cardiogenic pulmonary edema
- Heart sounds with presence of S3, S4, and harsh murmur
- JVD
Abdomen
- Abdomen examination of patients with pulmonary edema is usually normal.
Back
- Back examination of patients with pulmonary edema is usually normal.
Genitourinary
- Genitourinary examination of patients with pulmonary edema is usually normal.
Neuromuscular
- Neurologic examination may reveal focal signs as neurogenic causes of pulmonary edema.
Extremities
- Peripheral edema of extremities
References
- ↑ Ware LB, Matthay MA (December 2005). "Clinical practice. Acute pulmonary edema". N. Engl. J. Med. 353 (26): 2788–96. doi:10.1056/NEJMcp052699. PMID 16382065.