Thoracic aortic aneurysm physical examination
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Thoracic aortic aneurysm Microchapters |
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Differentiating Thoracic Aortic Aneurysm from other Diseases |
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Risk calculators and risk factors for Thoracic aortic aneurysm physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
A large thoracic aortic aneurysm may be associated with findings on physical examination secondary to aortic insufficiency (wide pulse pressure, diastolic murmur, heart failure) and compression of adjacent structures such as the recurrent laryngeal nerve (hoarseness), superior vena cava obstruction (selling of the face and neck), and the airway (stridor and wheezing).
Physical Examination
General
- The patient may be hoarse in the presence of an arch aneurysm due to compression of the recurrent laryngeal nerve
Vitals
- A widened pulse pressure may be present due to aortic insufficiency in the presence of an ascending aortic aneurysm
Neck
- Signs of superior vena cava obstruction such as a swollen face and neck may be present in the presence of an ascending aortic aneurysm
Cardiac
- Signs of aortic insufficiency and left ventricular heart failure may be present in the presence of an ascending aortic aneurysm
Pulmonary
2010 ACC/ AHA Guidelines - Recommendations for History and Physical Examination for Thoracic aortic disease (DO NOT EDIT)[1]
| Class I |
| 1. For patients presenting with a history of acute cardiac and noncardiac symptoms associated with a significant likelihood of thoracic aortic disease, the clinician should perform a focused physical examination, including a careful and complete search for arterial perfusion differentials in both upper and lower extremities, evidence of visceral ischemia, focal neurological deficits, a murmur of aortic regurgitation, bruits, and findings compatible with possible cardiac tamponade. (Level of Evidence: C) |
References
- ↑ Hiratzka LF, Bakris GL, Beckman JA; et al. (2010). "2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine". Circulation. 121 (13): e266–369. doi:10.1161/CIR.0b013e3181d4739e. PMID 20233780. Unknown parameter
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