Tuberculous pericarditis physical examination

Tuberculous pericarditis Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.

Physical Examination

Appearance of the Patient

• Patients with tuberculous pericarditis usually appear Cachectic.

Vital Signs

• Fever
• Tachycardia
• Pulsus paradoxus
• Hypotension (in cardiac tamponade)
• Tachypnea

Skin

• Skin examination of patients with tuberculous pericarditis is usually normal.

HEENT

• HEENT examination of patients with tuberculous pericarditis is usually normal.

Neck

• Jugular venous distension
• Kussmaul's sign
• Lymphadenopathy

Lungs

• Pleura dullness
• Decreased breath sounds
• Pericardial knock
• Pericardial rub
• Fine/coarse crackles upon auscultation of the lung

Heart

• distant heart sounds
• Displaced point of maximal impulse (PMI) suggestive of cardiomegaly
• Friction rub
• S4
• 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

• Hepatomegaly
• Ascites

Back

• Back examination of patients with tuberculous pericarditis is usually normal.

Genitourinary

• Genitourinary examination of patients with tuberculous pericarditis is usually normal.

Neuromuscular

• Neuromuscular examination of patients with tuberculous pericarditis is usually normal.

Extremities

• Pitting edema of the lower extremities