Alcoholic cardiomyopathy physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]; Hardik Patel, M.D.
Overview
Patients with alcoholic cardiomyopathy present with signs similar to that of heart failure. Most common findings include pedal edema, increased jugular venous pressure, pulmonary edema, and abnormal heart sounds.
Physical Examination
Appearance of the Patient
The patient may have altered mental status due to chronic alcoholism.
Vitals
- Hypertension may be present.
Neck
- Jugular venous distension may be seen in the presence of right heart failure.
Extremities
- Pedal edema
- Cold extremities with decreased pulse
Lungs
- Rales may be heard on lung exam due to pulmonary congestion.
Heart
Palpitation
- Enlargment of the heart with a laterally displaced and diffused point of maximal impulse.
Auscultation
- Abnormal heart sounds, namely third S3 and fourth S4 sounds may be heard.
- Apical murmur of mitral regurgitation and the lower parasternal murmur of tricuspid regurgitation may be present secondary to papillary muscle displacement and dysfunction.
Abdomen
Other sequelae of alcoholic liver disease may also be noted on physical examination.