Abdominal aortic aneurysm physical examination: Difference between revisions
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===Heart=== | ===Heart=== | ||
* Cardiovascular examination of patients with abdominal aortic aneurysm is usually normal. | * Cardiovascular examination of patients with abdominal aortic aneurysm is usually normal. | ||
* Tachycardia may be present in ruptured | *[[Tachycardia]] may be present in ruptured aneurysm. | ||
* | * Radiated [[bruit]] may be present in [[auscultation]]. | ||
===Abdomen=== | ===Abdomen=== | ||
====Inspection==== | ====Inspection==== | ||
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The presence of an [[abdominal bruit]] is nonspecific for a nonruptured aneurysm and can be present in cases of visceral or [[renal artery stenosis|renal arterial stenosis]] <ref name="Chaikof-2009">{{Cite journal | last1 = Chaikof | first1 = EL. | last2 = Brewster | first2 = DC. | last3 = Dalman | first3 = RL. | last4 = Makaroun | first4 = MS. | last5 = Illig | first5 = KA. | last6 = Sicard | first6 = GA. | last7 = Timaran | first7 = CH. | last8 = Upchurch | first8 = GR. | last9 = Veith | first9 = FJ. | title = The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines. | journal = J Vasc Surg | volume = 50 | issue = 4 Suppl | pages = S2-49 | month = Oct | year = 2009 | doi = 10.1016/j.jvs.2009.07.002 | PMID = 19786250 }}</ref>. | The presence of an [[abdominal bruit]] is nonspecific for a nonruptured aneurysm and can be present in cases of visceral or [[renal artery stenosis|renal arterial stenosis]] <ref name="Chaikof-2009">{{Cite journal | last1 = Chaikof | first1 = EL. | last2 = Brewster | first2 = DC. | last3 = Dalman | first3 = RL. | last4 = Makaroun | first4 = MS. | last5 = Illig | first5 = KA. | last6 = Sicard | first6 = GA. | last7 = Timaran | first7 = CH. | last8 = Upchurch | first8 = GR. | last9 = Veith | first9 = FJ. | title = The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines. | journal = J Vasc Surg | volume = 50 | issue = 4 Suppl | pages = S2-49 | month = Oct | year = 2009 | doi = 10.1016/j.jvs.2009.07.002 | PMID = 19786250 }}</ref>. | ||
==Management of Patients With Peripheral Artery Disease== | ===Management of Patients With Peripheral Artery Disease=== | ||
===Symptomatic Aortic or Iliac Aneurysms=== | ===Symptomatic Aortic or Iliac Aneurysms=== | ||
Revision as of 14:39, 7 January 2020
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Abdominal Aortic Aneurysm Microchapters |
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Differentiating Abdominal Aortic Aneurysm from other Diseases |
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Abdominal aortic aneurysm physical examination On the Web |
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Directions to Hospitals Treating Abdominal aortic aneurysm physical examination |
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Risk calculators and risk factors for Abdominal aortic aneurysm physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Hardik Patel, M.D. Ramyar Ghandriz MD[3]
Overview
A physical examination has low sensitivity in the detection of small abdominal aortic aneurysms (29-61% for abdominal aortic aneurysms 3.0-3.9 cm in diameter), but has a sensitivity of 76-82% in the detection those abdominal aortic aneurysms that are 5.0 cm or larger that may warrant repair. It is easier to detect a pulsatile mass in thin patients and those who do not have tense abdomens. Contrary to popular belief, gentle palpation of abdominal aortic aneurysms is safe and does not precipitate a rupture.
Physical Examination
General
Vital Signs
The following may or may not be present:
Skin
- Skin examination of patients with abdominal aortic aneurysm is usually normal.
HEENT
- HEENT examination of patients with abdominal aortic aneurysm is usually normal.
Neck
- Neck examination of patients with abdominal aortic aneurysm is usually normal.
Lungs
- Pulmonary examination of patients with abdominal aortic aneurysm is usually normal.
Heart
- Cardiovascular examination of patients with abdominal aortic aneurysm is usually normal.
- Tachycardia may be present in ruptured aneurysm.
- Radiated bruit may be present in auscultation.
Abdomen
Inspection
Flank ecchymosis (Grey Turner sign) may be present in cases of ruptured aneurysms due to retroperitoneal hemorrhage.
Palpation
A pulsating or non-pulsating abdominal mass may be palpable.
Auscultation
The presence of an abdominal bruit is nonspecific for a nonruptured aneurysm and can be present in cases of visceral or renal arterial stenosis [1].
Management of Patients With Peripheral Artery Disease
Symptomatic Aortic or Iliac Aneurysms
- Management of Patients With Peripheral Artery Disease (Compilation of 2005 and 2011 ACCF/AHA Guideline Recommendations) : A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.[2]
| Class I |
| "1.In patients with the clinical triad of abdominal and/or back pain, a pulsatile abdominal mass, and hypotension, immediate surgical evaluation is indicated.(Level of Evidence: B)" |
| "2.In patients with symptomatic aortic aneurysms, repair is indicated regardless of diameter. (Level of Evidence: C) " |
References
- ↑ Chaikof, EL.; Brewster, DC.; Dalman, RL.; Makaroun, MS.; Illig, KA.; Sicard, GA.; Timaran, CH.; Upchurch, GR.; Veith, FJ. (2009). "The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines". J Vasc Surg. 50 (4 Suppl): S2–49. doi:10.1016/j.jvs.2009.07.002. PMID 19786250. Unknown parameter
|month=ignored (help) - ↑ Rooke TW, Hirsch AT, Misra S, Sidawy AN, Beckman JA, Findeiss L; et al. (2013). "Management of patients with peripheral artery disease (compilation of 2005 and 2011 ACCF/AHA Guideline Recommendations): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. 61 (14): 1555–70. doi:10.1016/j.jacc.2013.01.004. PMC 4492473. PMID 23473760.