Patients with Brugada syndrome usually appear usually normal. Physical examination of patients with Brugada syndrome is usually remarkable by [[vagal maneuvers]] such as [[carotid sinus massage]] may increase vagal tone and may unmask the presence of a Type I Brugada pattern.<ref name="CrossonHanash20102">{{cite journal|last1=Crosson|first1=JaneE|last2=Hanash|first2=CarlaR|title=Emergency diagnosis and management of pediatric arrhythmias|journal=Journal of Emergencies, Trauma, and Shock|volume=3|issue=3|year=2010|pages=251|issn=0974-2700|doi=10.4103/0974-2700.66525}}</ref>
The presence of recent symptoms such as syncope, it is important to check the temperature in so far as fever may trigger a self terminating or sustained episode of [[ventricular tachycardia]] / [[ventricular fibrillation]]. The presence of fever is also a target of antipyretic therapy on physical examination is highly suggestive of Brugada syndrome.<ref name="Al-KhatibStevenson2018">{{cite journal|last1=Al-Khatib|first1=Sana M.|last2=Stevenson|first2=William G.|last3=Ackerman|first3=Michael J.|last4=Bryant|first4=William J.|last5=Callans|first5=David J.|last6=Curtis|first6=Anne B.|last7=Deal|first7=Barbara J.|last8=Dickfeld|first8=Timm|last9=Field|first9=Michael E.|last10=Fonarow|first10=Gregg C.|last11=Gillis|first11=Anne M.|last12=Granger|first12=Christopher B.|last13=Hammill|first13=Stephen C.|last14=Hlatky|first14=Mark A.|last15=Joglar|first15=José A.|last16=Kay|first16=G. Neal|last17=Matlock|first17=Daniel D.|last18=Myerburg|first18=Robert J.|last19=Page|first19=Richard L.|title=2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death|journal=Circulation|volume=138|issue=13|year=2018|issn=0009-7322|doi=10.1161/CIR.0000000000000549}}</ref>
* Patients with Brugada syndrome usually appear usually normal. Physical examination of patients with Brugada syndrome is usually remarkable by [[vagal maneuvers]] such as [[carotid sinus massage]] may increase vagal tone and may unmask the presence of a Type I Brugada pattern.<ref name="CrossonHanash20102">{{cite journal|last1=Crosson|first1=JaneE|last2=Hanash|first2=CarlaR|title=Emergency diagnosis and management of pediatric arrhythmias|journal=Journal of Emergencies, Trauma, and Shock|volume=3|issue=3|year=2010|pages=251|issn=0974-2700|doi=10.4103/0974-2700.66525}}</ref>
===Appearance of the Patient===
* The presence of recent symptoms such as syncope, it is important to check the temperature in so far as fever may trigger a self terminating or sustained episode of [[ventricular tachycardia]] / [[ventricular fibrillation]]. The presence of fever is also a target of antipyretic therapy on physical examination is highly suggestive of Brugada syndrome.<ref name="Al-KhatibStevenson2018">{{cite journal|last1=Al-Khatib|first1=Sana M.|last2=Stevenson|first2=William G.|last3=Ackerman|first3=Michael J.|last4=Bryant|first4=William J.|last5=Callans|first5=David J.|last6=Curtis|first6=Anne B.|last7=Deal|first7=Barbara J.|last8=Dickfeld|first8=Timm|last9=Field|first9=Michael E.|last10=Fonarow|first10=Gregg C.|last11=Gillis|first11=Anne M.|last12=Granger|first12=Christopher B.|last13=Hammill|first13=Stephen C.|last14=Hlatky|first14=Mark A.|last15=Joglar|first15=José A.|last16=Kay|first16=G. Neal|last17=Matlock|first17=Daniel D.|last18=Myerburg|first18=Robert J.|last19=Page|first19=Richard L.|title=2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death|journal=Circulation|volume=138|issue=13|year=2018|issn=0009-7322|doi=10.1161/CIR.0000000000000549}}</ref>
*Patients with [disease name] usually appear [general appearance].
===Vital Signs===
*High-grade / low-grade fever
*[[Hypothermia]] / hyperthermia may be present
*[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse
*[[Bradycardia]] with regular pulse or (ir)regularly irregular pulse
*Tachypnea / bradypnea
*Kussmal respirations may be present in _____ (advanced disease state)
*High/low blood pressure with normal pulse pressure / [[wide pulse pressure]] / [[narrow pulse pressure]]
===Skin===
* Skin examination of patients with [disease name] is usually normal.
OR
*[[Cyanosis]]
*[[Jaundice]]
* [[Pallor]]
* Bruises
<gallery widths="150px">
UploadedImage-01.jpg | Description {{dermref}}
UploadedImage-02.jpg | Description {{dermref}}
</gallery>
===HEENT===
* HEENT examination of patients with [disease name] is usually normal.
OR
* Abnormalities of the head/hair may include ___
* Evidence of trauma
* Icteric sclera
* [[Nystagmus]]
* Extra-ocular movements may be abnormal
*Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
*Ophthalmoscopic exam may be abnormal with findings of ___
* Hearing acuity may be reduced
*[[Weber test]] may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
*[[Rinne test]] may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
* [[Exudate]] from the ear canal
* Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
* Neck examination of patients with [disease name] is usually normal.
OR
*[[Jugular venous distension]]
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
*[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
*[[Thyromegaly]] / thyroid nodules
*[[Hepatojugular reflux]]
===Lungs===
* Pulmonary examination of patients with [disease name] is usually normal.
OR
* Asymmetric chest expansion OR decreased chest expansion
*Lungs are hyporesonant OR hyperresonant
*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
*Rhonchi
*Vesicular breath sounds OR distant breath sounds
*Expiratory wheezing OR inspiratory wheezing with normal OR delayed expiratory phase
*[[Wheezing]] may be present
*[[Egophony]] present/absent
*[[Bronchophony]] present/absent
*Normal/reduced [[tactile fremitus]]
===Heart===
* Cardiovascular examination of patients with [disease name] is usually normal.
OR
*Chest tenderness upon palpation
*PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
*[[Heave]] / [[thrill]]
*[[Friction rub]]
*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
*[[Heart sounds#Third heart sound S3|S3]]
*[[Heart sounds#Fourth heart sound S4|S4]]
*[[Heart sounds#Summation Gallop|Gallops]]
*A high/low grade early/late [[systolic murmur]] / [[diastolic murmur]] best heard at the base/apex/(specific valve region) may be heard using the bell/diaphgram of the stethoscope
===Abdomen===
* Abdominal examination of patients with [disease name] is usually normal.
OR
*[[Abdominal distension]]
*[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant
*[[Rebound tenderness]] (positive Blumberg sign)
*A palpable abdominal mass in the right/left upper/lower abdominal quadrant
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Overview
Patients with Brugada syndrome usually appear usually normal. Physical examination of patients with Brugada syndrome is usually remarkable by vagal maneuvers such as carotid sinus massage may increase vagal tone and may unmask the presence of a Type I Brugada pattern.
The presence of recent symptoms such as syncope, it is important to check the temperature in so far as fever may trigger a self terminating or sustained episode of ventricular tachycardia / ventricular fibrillation. The presence of fever is also a target of antipyretic therapy on physical examination is highly suggestive of Brugada syndrome.
Physical Examination
Patients with Brugada syndrome usually appear usually normal. Physical examination of patients with Brugada syndrome is usually remarkable by vagal maneuvers such as carotid sinus massage may increase vagal tone and may unmask the presence of a Type I Brugada pattern.[1]
The presence of recent symptoms such as syncope, it is important to check the temperature in so far as fever may trigger a self terminating or sustained episode of ventricular tachycardia / ventricular fibrillation. The presence of fever is also a target of antipyretic therapy on physical examination is highly suggestive of Brugada syndrome.[2]
References
↑Crosson, JaneE; Hanash, CarlaR (2010). "Emergency diagnosis and management of pediatric arrhythmias". Journal of Emergencies, Trauma, and Shock. 3 (3): 251. doi:10.4103/0974-2700.66525. ISSN0974-2700.
↑Al-Khatib, Sana M.; Stevenson, William G.; Ackerman, Michael J.; Bryant, William J.; Callans, David J.; Curtis, Anne B.; Deal, Barbara J.; Dickfeld, Timm; Field, Michael E.; Fonarow, Gregg C.; Gillis, Anne M.; Granger, Christopher B.; Hammill, Stephen C.; Hlatky, Mark A.; Joglar, José A.; Kay, G. Neal; Matlock, Daniel D.; Myerburg, Robert J.; Page, Richard L. (2018). "2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death". Circulation. 138 (13). doi:10.1161/CIR.0000000000000549. ISSN0009-7322.